Pilot testing a mindfulness-based weight loss maintenance intervention to enhance outcomes after bariatric surgery

      Background: Weight regain is a problem for many patients after bariatric surgery. We randomly assigned 79 patients undergoing sleeve gastrectomy (SG) to either treatment as usual (TAU; n = 39) or to six weekly sessions of a mindfulness intervention (MI; n = 40), beginning 5- 8 months after SG. The mindfulness approach, originally developed to help prevent substance abuse relapse, was designed to address challenges in weight maintenance.Six validated self-report instruments (Tables 1, 2) were assessed at study baseline and 6 weeks later (end of the intervention). Percent total weight loss (%TWL) was calculated at study baseline and 6- and 18-month follow-up (12 and 24 months post-op). No significant group differences were found for %TWL at 12 months (mean %TWL for MI = 21.69%, SD=8.04; for TAU = 21.05%, SD=9.70, t (71) =.307, p =.76) or for weight regain at 6-month follow up. Several significant correlations were noted between mindfulness measures and %TWL at various time points (Tables 1 and 2), including a relationship between baseline craving levels and %TWL. Despite adequate power, we failed to observe a group effect on weight regain. A limitation of the study is that half of the MI participants missed half of the sessions and only 8/40 participants attended all six MI sessions. Participant feedback was overwhelmingly positive. We feel that further interventions post bariatric surgery should focus on food cravings and emotional regulation, possibly targeting a more narrowly defined group of patients struggling with weight regain at an earlier time point after surgery.
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