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Abstract

The growing obesity epidemic is paralleled by an increasing number of bariatric surgeries. Patients lose significant weight within the first 12-18 months post-surgery with corresponding resolution of many co-morbidities. However, weight loss stabilizes after 18-24 months and 50% or more of patients eventually regain weight (Bond, Phelan, Leahey, Hill, & Wing, 2009; Magro, et al., 2008). Weight regain after loss is associated with return of co-morbidities and deteriorations in health-related quality of life and mood (Karlsson, Taft, Ryden, Sjostrom, & Sullivan, 2007). The purpose of this pilot study was to analyze the effects of a post-surgical behavioral plus counseling intervention on bariatric surgery patients who are struggling to maintain their weight loss ≥ 2 years after surgery. Methods: Project REACH (Relearn how to Eat, increase Activity and Create better Habits) was a 12-week intervention designed to change psychosocial mediators of health behaviors and fitness variables. Patients met for 1 hr each week for cognitive behavior modification and exercise instruction and practice followed by 1 hr of a closed counseling session. Psychosocial variables and fitness were measured before and after the intervention. Descriptive statistics, paired-samples t-tests, and Cohen’s d were applied to the data. Results: Eight women aged 39-68 yr (M = 54.37, SD = 9.62), BMI range 24.4-50.5 kg/m2 (M = 38.16, SD = 7.61) self-selected into the program. At the pre-test, BMI was correlated with diet/lifestyle self-efficacy (r = -.913, p = .002), social support for exercise-friends (r = -.800, p = .017), and exercise planning (r = -.730, p = .040). Distance walked in 6 min (6MWT) increased for the 4 women who completed the post-test (p = .040, d = 1.68). Changes in some fitness (e.g., BMI: d = -0.77) and psychosocial variables (e.g., exercise planning: d = 1.02; dietary cognitive restraint: d = 0.73) had medium and large effects. Conclusions: Targeting exercise, nutrition, and psychological issues together in an intervention can have positive effects on fitness and psychosocial factors that may help patients more than 2 yr post-surgery manage their weight.

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