Survey of bariatric surgical patients' experiences with behavioral and psychological services

Bariatric surgery continues to grow in popularity as a treatment of obesity; however, weight regain and noncompliance with behavioral recommendations remain an issue. Little is known about the type and frequency of services completed by bariatric patients and their satisfaction with these services. However, preliminary research has shown that the use of behavioral and psychological services is less common after surgery. We assessed the behavioral and psychological services completed by bariatric patients before and after surgery, patient satisfaction with the surgery and services, and the relationship between the completed services and the outcomes. The participants were solicited for participation using an on-line support Web site dedicated to obesity and bariatrics.

A convenience sample of 380 subjects were included in the present study. They completed an Internet-based survey that assessed the psychological, dietary, exercise, and lifestyle services completed before and after surgery, their satisfaction with these services, and their weight loss outcomes.

Overall, the participants reported completing more services before surgery. After surgery, the most frequently reported services completed were support groups and dietary consultation. More than one half of the participants did not meet with either a mental health professional or an exercise professional after surgery. The participants expressed high satisfaction with their surgery and services, with exercise services receiving the lowest satisfaction rating. A statistically significant relationship was found between the total number of postoperative psychological and behavioral services completed and a greater percentage of excess weight lost. The t tests showed that participants who completed group exercise sessions and nutritional consultation after surgery lost more weight than did those who did not complete these services.

The participants in the present sample reported completing few behavioral and psychological services after surgery. However, our findings showed that these services could promote greater weight loss and maintenance. Thus, it is recommended that bariatric facilities and insurance providers consider requiring patients to complete postoperative behavioral modification programs that target improvement in diet and physical activity behaviors.