Background

Patients undergoing bariatric surgery have high rates of psychiatric comorbidity, which may increase their vulnerability to COVID-19-related mental health distress. Exacerbation of mental health distress and disordered eating could have significant negative effects on long-term weight management and quality of life for these patients if untreated.Objective: To determine the efficacy of a telephone-based cognitive behavioural therapy (Tele-CBT) intervention in improving depressive, anxiety and disordered eating symptoms during COVID-19.

Methods

Participants were recruited as part of a larger randomized controlled trial study (clinicaltrials.gov ID: NCT03315247) between March 2020 and March 2021 and randomized 1:1 to receive Tele-CBT or standard bariatric care. Outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3-months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome.

Results

Eighty-one patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.68 (9.36) years and 80.2% were female. There were significant group-by-time interactions for all outcomes and significant differences between groups across time. There were significant decreases in mean GAD-7 (p=0.001), PHQ-9 (p<0.001), EES-Total (p=0.001), EES-Anger (p=0.003), EES-Anxiety (p<0.001), EES-Depression (p<0.001) and BES (p=0.002) scores for the Tele-CBT group at post-intervention and follow-up when compared to baseline and the control group.

Conclusions

Tele-CBT is a feasible and effective treatment for improving psychological distress and disordered eating among post-operative bariatric surgery patients during the COVID-19 pandemic.