Does Post-operative Psychotherapy Contribute to Improved Comorbidities in Bariatric Patients with Borderline...

Borderline personality disorder (BPD) and eating disorders may affect the outcomes of bariatric surgery. This study was aimed to evaluate the influence of a post-operative dialectical behavioral therapy (DBT) intervention on weight loss and comorbidities in a sample of comorbid obese Italian patients with BPD traits and bulimia tendencies who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB).

One hundred fifty-four LRYGB or LAGB patients showing BPD and bulimia traits and type II diabetes, hypertension, and/or sleep apnea (OSAS) voluntarily adhered to DBT (n = 72) or treatment as usual (n = 82) for 12 months after surgery. Total weight loss (%TWL) and remission/improvement of comorbidities were considered as outcomes. Differences between treatment groups and between LRYGB and LAGB subgroups were evaluated through Student's t test for TWL and chi-square test for comorbidities.

DBT was more effective than treatment as usual (TAU) in reducing weight loss (p < .001). Reduction of comorbidities was higher in patients treated with DBT, as for diabetes (p = .68), hypertension (p = .02), and OSAS (p = .03). LRYGB outcomes seem to be significantly better than those of LAGB, mainly in TAU group.

Our findings confirm the effectiveness of DBT in enhancing post-bariatric weight loss and reduction of comorbidities in patients showing BPD traits and bulimia tendencies. Further in-depth investigations and a longer follow-up are needed to strengthen these results.