The role of brief strategic therapy on the outcome of gastric banding

Background: The success of bariatric surgery can be measured in different ways and depends on many factors. The aim of this study was to assess if preoperative Brief Strategic Therapy (BST), a specific psychological support, can positively influence the results (weight loss, improvement in health status and quality of life, QOL) in the short- and long-term. Methods: 500 patients who underwent laparoscopic adjustable gastric banding from 1996 to 1999 were evaluated both objectively (weight loss, health status) and subjectively (improvement in QOL and self-perception). We compared these results with those of a group of 145 patients treated with preoperative BST (6 sessions average). Patients were divided into 3 groups according to the percent of excess weight loss (<40%, 40-60%, >60%). The Moorehead-Ardelt QOL Questionnaire scoring was used. Individual interviews were conducted to understand emotional feelings and to. evaluate the actual changes in the QOL and eating habits. Results: Patients treated preoperatively with BST had 46% excess weight loss (EWL) at 1 year which was significally different from patients non-treated (40% EWL). In the following years, treated patients showed better results, although not statistically significant. QOL improved objectively and subjectively Conclusion: Preoperative BST gives a satisfactory result. In addition, good compliance preoperatively corrected eating habits that has been maintained through the years and is a good predictor of long-term success.