Tratamientos psicológicos para el mejoramiento de las conductas alimentarias desadaptativas en pacientes de cirugía bariátrica: revisión sistemática
DOI:
https://doi.org/10.19230/jonnpr.3865Palabras clave:
Conductas alimentarias desadaptativas, Tratamiento psicológico, Psicoterapia, Cirugía bariátrica, Revisión sistemáticaResumen
Introducción. Las conductas alimentarias desadaptativas (CAD) son altamente prevalecientes en los pacientes de cirugía bariátrica y han sido demostradas ser contribuyentes importantes en los resultados de la pérdida de peso. Una revisión sistemática fue realizada para evaluar la efectividad de los enfoques de tratamientos psicológicos en CAD, en pacientes de cirugía bariátrica.
Materiales y métodos. Esta revisión sistemática fue registrada en PROSPERO. La revisión de la literatura fue realizada en las bases de datos de PubMed, ScienceDirect, Cochrane Library y Web of Science. Incluimos estudios publicados entre 1 de enero de 1990 y 18 de octubre de 2019, con enfoques de tratamiento psicológico pre o posoperatorio en pacientes de cirugía bariátrica destinados a mejorar las CAD.
Resultados. Un total de 15 estudios reunieron los criterios de inclusión (ocho ensayos clínicos aleatorizados (ECA) y y siete estudios preprueba-postprueba),752 participantes fueron identificados, 80.3% fueron mujeres y la edad promedio de los participantes fue de 46.1 años (DE ± 6.6). El periodo de seguimiento después de la intervención varió de seis semanas a 48 meses. Cinco de ocho ECA informaron un efecto positivo significativo (P <0.05) en las CAD y cuatro tuvieron un efecto de medio a alto entre los grupos que recibieron intervenciones psicoterapeúticas y el grupo control. Seis de los siete estudios preprueba-postprueba reportaron diferencias significativas (P <0.05) en las CAD y tuvieron un tamaño de efecto de bajo a alto después de recibir intervenciones psicoterapéuticas.
Conclusión. En suma, la calidad de la evidencia varió de baja a moderada. Los tratamientos psicológicos en pacientes de cirugía bariátrica son inconsistentes, aunque la mayoría de los resultados indican un mejoramiento en las CAD. Estudios bien diseñados y otras estrategias de enfoque son garantizados para para evaluar los efectos a largo plazo de las CAD y la pérdida de peso en pacientes de cirugía bariátrica.
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M. Ng, T. Fleming, M. Robinson, et al., "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013," The Lancet, vol. 384, no. 9945, pp.766-81, 2014.
World Health Organization, "Obesity and overweight 2018," (Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight).
C.M. Hales, M. D. Carroll, C. D. Fryar, C. L. Ogden, "Prevalence of Obesity Among Adults and Youth: United States, 2015–2016," NCHS Data Brief, vol. 288, pp. 1-8, 2017.
E. P. Williams, M. Mesidor, K. Winters, P. M. Dubbert, S. B. Wyatt, "Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem," Current obesity reports, vol. 14, no. 3, pp. 363-70, 2015.
M. Fried, V. Yumuk, J. M. Oppert, et al., "Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery," Obes Surg, vol. 24, no. 1, pp. 42-55, 2014.
National Heart, Lung, and Blood Institute - NIH, "Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report Rockville, Md: National Heart, Lung, and Blood Institute," 1998.
I. Rasera Jr, A. Luque, S.M. Junqueira Jr, N. C. Brasil, P. C. Andrade, "Effectiveness and Safety of Bariatric Surgery in the Public Healthcare System in Brazil: Real-World Evidence from a High-Volume Obesity Surgery Center," Obes Surg, vol. 27, no. 2, pp. 536-40, 2017.
N. Puzziferri, T. B. Roshek 3rd, H. G. Mayo, R. Gallagher, S. H. Belle, E. H. Livingston, "Long-term follow-up after bariatric surgery: a systematic review," JAMA, vol. 312, no. 9, pp. 934-42, 2014.
S. H. Chang, C. R. Stoll, J. Song, J.E Varela, C. J. Eagon, G. A, Colditz, "The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012," JAMA surgery, vol. 149, no. 3, pp. 275-87, 2014.
M. Khosravi-Largani, M. Nojomi, R. Aghili, et al., "Evaluation of all Types of Metabolic Bariatric Surgery and its Consequences: a Systematic Review and Meta-Analysis," Obes Surg, vol. 29, no. 2, pp. 651-690, 2019.
P. Ruiz-Cota, M. Bacardi-Gascon, A. Jimenez-Cruz A, "Long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: A systematic review," Surg Obes Relat Dis, vol. 15, no. 1, pp. 133-144, 2019.
P.E. O'Brien, A. Hindle, L. Brennan, et al., "Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding," Obes Surg, vol. 29, no. 1, pp. 3-14, 2019.
Z. Khorgami, S. Shoar , A. A. Saber, C. A. Howard, G. Danaei, G. M. Sclabas, "Outcomes of Bariatric Surgery Versus Medical Management for Type 2 Diabetes Mellitus: a Meta-Analysis of Randomized Controlled Trials," Obes Surg, vol. 29, no. 3, pp. 964-974, 2019.
J. P. Mann, A. D. Jakes, J. D. Hayden, J. H. Barth, "Systematic review of definitions of failure in revisional bariatric surgery," Obes Surg, vol. 25, no. 3, pp. 571-4, 2015.
American Society for Metabolic and Bariatric Surgery, "Bariatric Surgery Misconceptions," (Available from: https://asmbs.org/patients/bariatric-surgery-misconceptions).
M. Livhits, C. Mercado, I. Yermilov, et al., "Behavioral factors associated with successful weight loss after gastric bypass," Am Surg, vol. 76, no. 10, pp. 1139-42, 2010.
L. Salem, C. C. Jensen, D. R. Flum, "Are bariatric surgical outcomes worth their cost? A systematic review," J Am Coll Surg, vol. 200, no. 2, pp. 270-8, 2005.
N. J. Switzer, S. Karmali, R. S. Gill, V. Sherman, "Revisional Bariatric Surgery," Surg Clin North Am, vol. 96, no. 4, pp. 827-42, 2016.
G. M. Campos, C. Rabl, K. Mulligan, et al., "Factors associated with weight loss after gastric bypass," Arch Surg, vol. 143, no. 9, pp. 877-83, 2008.
D. B. Sarwer, T. A. Wadden, A. N. Fabricatore, "Psychosocial and behavioral aspects of bariatric surgery," Obes Res, vol. 13, no. 4, pp. 639-48, 2005.
A. Maleckas, R. Gudaitytė, R. Petereit, L. Venclauskas, D. Veličkienė, "Weight regain after gastric bypass: etiology and treatment options," Gland surgery, vol. 5, no. 6, pp. 617-24, 2016.
J. Odom, K. C. Zalesin, T. L. Washington, et al., "Behavioral Predictors of Weight Regain after Bariatric Surgery," Obes Surg, vol. 20, no. 3, pp. 349-56, 2010.
J. E. Mitchell, W. C. King, A. Courcoulas, et al., "Eating behavior and eating disorders in adults before bariatric surgery," Int J Eat Disord, vol. 48, no. 2, pp. 215-22, 2015.
E. Conceição, J. E. Mitchell, A. R. Vaz, et al., "The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: Importance of picking or nibbling on weight regain," Eating Behaviors, vol. 15, no. 4, pp. 558-62, 2014.
A. Pinto-Bastos, M. de Lourdes, I. Brandão, P. P. P Machado, E .M Conceição, "Weight loss trajectories and psychobehavioral predictors of outcome of primary and reoperative bariatric surgery: a 2-year longitudinal study," Surg Obes Relat Dis, vol. 15, no. 7, pp. 1104-112, 2019.
M. A. Kalarchian, W. C. King, M. J. Devlin, et al., "Psychiatric Disorders and Weight Change in a Prospective Study of Bariatric Surgery Patients: A 3-Year Follow-Up," Psychosom Med, vol. 78, no. 3, pp. 373-81, 2016.
C. S. Brode, J.E. Mitchell, "Problematic Eating Behaviors and Eating Disorders Associated with Bariatric Surgery," Psychiatr Clin North Am, vol. 42, no. 2, pp. 287-97, 2019.
M. A. Kalarchian, M. D. Marcus, M.D. Levine, et al., "Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status," Am J Psychiatry, vol. 164, no. 2, pp. 328-34, 2007.
G. A. Williams-Kerver, K. J. Steffen, J. E. Mitchell, "Eating Pathology After Bariatric Surgery: an Updated Review of the Recent Literature," Current psychiatry reports, vol. 21, no. 9, pp. 86, 2019.
L. R. Miller-Matero, K. Bryce, C. K. Saulino, K. E. Dykhuis, J. Genaw, A. M. Carlin, "Problematic Eating Behaviors Predict Outcomes After Bariatric Surgery," Obes Surg, vol. 28, no. 7, pp. 1910-5, 2018.
S. M. Himes, K. B. Grothe, M. M. Clark, J. M. Swain, M. L. Collazo-Clavell, M. G. Sarr, "Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain," Obes Surg, vol. 25, no. 5, pp. 922-7, 2015.
N. N. Beck, M. Johannsen, R. K. Stoving, M. Mehlsen, R. Zachariae, "Do postoperative psychotherapeutic interventions and support groups influence weight loss following bariatric surgery? A systematic review and meta-analysis of randomized and nonrandomized trials," Obes Surg, vol. 22, no. 11, pp. 1790-7, 2012.
A. Rudolph, A. Hilbert, "Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials," Obes Rev, vol. 14, no. 4, pp. 292-302, 2013.
F. Stewart, A. Avenell, "Behavioural Interventions for Severe Obesity Before and/or After Bariatric Surgery: a Systematic Review and Meta-analysis," Obes Surg, vol. 26, no. 6, pp. 1203-14, 2016.
J. A. Brewer, A. Ruf, A. L. Beccia, et al., "Can Mindfulness Address Maladaptive Eating Behaviors? Why Traditional Diet Plans Fail and How New Mechanistic Insights May Lead to Novel Interventions," Front Psychol, vol. 9, pp. 1418, 2018.
A. Wenzel, "Basic Strategies of Cognitive Behavioral Therapy2," Psychiatr Clin North Am, vol. 40, no. 4, pp. 597-609, 2017.
D. Moher, L. Shamseer, M. Clarke, et al., "Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement," Syst Rev, vol. 4, no. 1, 2015.
GRADE Work Group, "Grading quality of evidence and strength of recommendations," BMJ, vol. 328, no. 7454, pp. 490, 2004.
S. E. Cassin, S. Sockalingam, C. Du, S. Wnuk, R. Hawa, S. V. Parikh, "A pilot randomized controlled trial of telephone-based cognitive behavioural therapy for preoperative bariatric surgery patients," Behav Res Ther, vol. 80, pp. 17-22, 2016.
A. S. Chacko, G. Y. Yeh GY, R. B. Davis, C. C. Wee, "A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial," Complement Ther Med, vol. 28, pp. 13-21, 2016.
L. A. David, S. Sockalingam, S. Wnuk, S. E. Cassin, "A pilot randomized controlled trial examining the feasibility, acceptability, and efficacy of Adapted Motivational Interviewing for post-operative bariatric surgery patients," Eat Behav, vol. 22, pp. 87-92, 2016.
H. Gade, O. Friborg, J. H. Rosenvinge, M. C Smastuen, J. Hjelmesaeth J, "The Impact of a Preoperative Cognitive Behavioural Therapy (CBT) on Dysfunctional Eating Behaviours, Affective Symptoms and Body Weight 1 Year after Bariatric Surgery: A Randomised Controlled Trial," Obes Surg, vol. 25, no. 11, pp. 2112-9, 2015.
H. Gade, J. Hjelmesæth, J. H. Rosenvinge, O. Friborg, "Effectiveness of a Cognitive Behavioral Therapy for Dysfunctional Eating among Patients Admitted for Bariatric Surgery: A Randomized Controlled Trial," J Obes, 2014.
J. Hjelmesaeth, J. H. Rosenvinge, H. Gade, O. Friborg, "Effects of Cognitive Behavioral Therapy on Eating Behaviors, Affective Symptoms, and Weight Loss After Bariatric Surgery: a Randomized Clinical Trial," Obes Surg, vol. 29, no. 1, pp. 61-9, 2019.
A. Papalazarou, M. Yannakoulia, S. A. Kavouras, et al., "Lifestyle intervention favorably affects weight loss and maintenance following obesity surgery," Obesity (Silver Spring, Md), vol. 18, no, 7, pp. 1348-53, 2010.
S. Weineland, D. Arvidsson, T. P Kakoulidis, J. Dahl, "Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT," Obes Res Clin Pract, vol. 6, no. 1, pp. e1-e90, 2012.
B. Wild, K. Hunnemeyer, H. Sauer H, et al., "A 1-year videoconferencing-based psychoeducational group intervention following bariatric surgery: results of a randomized controlled study," Surg Obes Relat Dis, vol. 11, no. 6, pp. 1349-60, 2015.
B. Wild, K. Hunnemeyer, H. Sauer, et al., "Sustained effects of a psychoeducational group intervention following bariatric surgery: follow-up of the randomized controlled BaSE study," Surg Obes Relat Dis, vol. 13, no. 9, pp. 1612-8, 2017.
K. Ashton, M. Drerup, A. Windover, L. Heinberg, "Brief, four-session group CBT reduces binge eating behaviors among bariatric surgery candidates," Surg Obes Relat Dis, vol. 5, no. 2, pp. 257-62, 2009.
J. Beaulac, D. Sandre, "Impact of a CBT psychotherapy group on post-operative bariatric patients," SpringerPlus, vol. 4, pp. 764, 2015.
L. E. Bradley, E. M Forman, S. D. Kerrigan, M. L. Butryn, J. D. Herbert, D. B. Sarwer, "A Pilot Study of an Acceptance-Based Behavioral Intervention for Weight Regain After Bariatric Surgery," Obes Surg, vol. 26, no. 10, pp. 2433-41, 2016.
L. E. Bradley, E. M. Forman, S. G. Kerrigan, et al., "Project HELP: a Remotely Delivered Behavioral Intervention for Weight Regain after Bariatric Surgery," Obes Surg, vol. 27, no. 3, pp. 586-98, 2017.
S. Sockalingam, S. E. Cassin, S Wnuk, et al, "A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery," Obes Surg, vol. 27, no. 3, pp. 670-5, 2017.
S. M. Wnuk, C. M. Du, J. Van Exan, et al., "Mindfulness-Based Eating and Awareness Training for Post-Bariatric Surgery Patients: a Feasibility Pilot Study," Mindfulness, vol. 9, no. 3, pp. 949-60, 2018.
C. L. Wimmelmann, F. Dela, E. L. Mortensen, "Psychological predictors of weight loss after bariatric surgery: A review of the recent research," Obes Res Clin Pract, vol. 8, no. 4, pp. e299-e313, 2014.
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In Memoriam Jesús Manuel Culebras Fernández 
