Abstract / Summary
Background : Mental health conditions such as depression, anxiety, disordered eating, and alcohol misuse are common after metabolic bariatric surgery and are associated with weight regain, negatively affecting long-term outcomes and quality of life. Objective: To evaluate the effects of virtual and in-person group cognitive-behavioral therapy (CBT) on mental health symptoms and anthropometric outcomes in post-bariatric patients. Methods : This three-arm randomized controlled trial included 54 post-bariatric participants allocated to virtual CBT (n = 18), in-person CBT (n = 18), or a control group (n = 18). Due to attrition, 37 participants completed the study (virtual, n = 13; in-person, n = 12; control, n = 12). The intervention consisted of 12 weekly group CBT sessions delivered within a multidisciplinary framework. Outcomes were assessed at baseline (T 0 ), post-intervention (T 1 ), and six-month follow-up (T 2 ), including depression (BDI-II), anxiety (GAD-7), binge eating (BES), alcohol use (AUDIT), and anthropometric measures. Results : High rates of mental disorders were observed (84 % current; 95 % lifetime). No significant interaction effects were observed, but significant improvements over time were found for depression (mean reduction = 7.5 points; 95 % CI [−12.4, −2.6]; p = 0.001), anxiety (3.3 points; 95 % CI [−5.5, −1.1]; p = 0.001), and binge eating (3.9 points; 95 % CI [−7.3, −0.5]; p = 0.02). No significant change was observed in alcohol use ( p = 0.35). Abdominal circumference decreased over time (−5 % at T 2 ; p = 0.003). Conclusions : Group CBT was feasible and well accepted. Improvements over time, despite the absence of between-group differences, suggest both delivery formats may be beneficial. Further studies are needed to clarify intervention-specific effects. Trial registration: Brazilian Registry of Clinical Trials (ReBEC), RBR-85t3hdf.