Moving Towards Precision-Based Care in Bariatric and Metabolic Surgery: Predictors of Response To Telephone-Based...

A telephone-based Cognitive Behavioral Therapy (Tele-CBT) has been shown to reduce disordered eating and psychological distress after metabolic and bariatric surgery (MBS). However, it remains unclear which patients benefit most. This study aimed to identify predictors of response in a larger sample of Tele-CBT completers.

Data from four clinical trials were analyzed. Participants (n= 204) received at least six Tele-CBT sessions and completed surveys pre- and post-intervention. Response was defined as changes in binge eating based on residualized gain scores from the Binge Eating Scale (BES). Demographic variables, Rurality Index of Ontario (RIO) scores, timing of Tele-CBT, surgery type, and baseline symptoms were examined as predictors.

Multivariate linear regression showed that predictors explained 9.7% of the variance in Tele-CBT response (R² = 0.097, F(11, 192)= 1.874, p = 0.063). Raw RIO scores (β = -0.067, p= 0.017), education (β = 0.939, p = 0.045), and race (β = 2.130, p = 0.043) were significant predictors.

Rural residency was associated with greater Tele-CBT benefit, while higher education and White racial identity were associated with less improvement. These findings highlight the potential importance of sociodemographic factors in shaping response to Tele-CBT, suggesting avenues for more tailored approaches in future bariatric care.