Abstract/Summary

Background: Although bariatric surgery is widely considered the most effective form of obesity management, some patients receiving surgery describe how their psychological issues remain neglected. This study evaluated the impact of additional psychological support (a Bariatric Rehabilitation Service (BRS)) on patients’ psychological outcomes at 12 months and their experiences of the bariatric service at 24 months. Methods: Patients were randomised to receive either usual care or the BRS and rated a range of psychological outcomes at 12 months. Completed psychological data was obtained from 70 patients (usual care: n=32; BRS: n=38). At 24 months post surgery patients (n=68) gave written feedback regarding the content and timing of their experiences and a sub group (n=16) took part in telephone interviews about their experiences of the bariatric service they had received. Results: By 12 months those who received the BRS reported greater improvement in their psychological outcomes compared to the usual care group in terms of vigour (p=0.02, eta2=0.08), approach coping (p=0.04, eta2=0.06), quality of life (p=0.04, eta2=0.06) and self-reported hunger (p=0.05, eta2=0.05). By 24 months a large majority of those who had received the BRS reported satisfaction with the service’s timing and content. However the majority of all patients, regardless of condition, reported wanting further psychological support up to 24 months post-operatively. A minority, however, stated that as their problems were not emotional the additional support was unnecessary. Conclusion: The BRS resulted in some small improvements in psychological outcomes. Psychological support before and after surgery could be delivered in relation to individual patient need rather than as a blanket provision. Further research is needed to determine both the timing of such support and to identify those who would show most benefit.