Evidence-Based Psychological Interventions to Support an Adolescent Undergoing Bariatric Surgery: A Case Report
Abigail M. Romirowskya, Marissa R. Kushnerb, Camden Elliott Mathernec, Evan P. Nadlera, Eleanor Race Mackeya✉
- aDepartment of Psychology, Children’s National Health System, Washington, DC
- bDepartment of Psychology, Children’s National Health System, Washington, DC, and Department of Psychology, University of Maryland College Park
- cDepartment of Psychology, Children’s National Health System, Washington, DC, and Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
- ✉Corresponding author
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Abstract
The treatment of pediatric obesity is a recognized challenge, with mounting evidence that significant long-term weight loss maintenance is especially difficult. Additionally, obese youth display elevated rates of depression, anxiety, and binge eating, further complicating efforts to maximize and maintain weight loss. Thus, as bariatric surgery has become a more commonly used procedure for adolescents, psychological assessment has been incorporated into routine presurgical evaluations. However, no studies to date have examined the impact of psychological assessment and intervention on weight loss and psychosocial outcomes in adolescents presenting for bariatric surgery. In this case report, we sought to demonstrate the clinical effectiveness of an integrative and comprehensive empirically supported intervention addressing depression, anxiety, and binge eating with an obese adolescent female undergoing bariatric surgery. Psychosocial data were collected prior to and at discharge from therapy as well as 14 months postsurgery, while anthropometric data were collected at multidisciplinary outpatient appointments throughout the study period. After 11 months of weekly outpatient sessions, results indicated improvements across several areas of psychosocial functioning, including mood, anxiety, eating disorder symptoms, body esteem, and weight-related quality of life. Significant changes were also observed in health-related behaviors and overall weight loss. The current case highlights the importance of the presurgical identification of comorbid anxiety and depression, and the utility of treating these conditions prior to surgery in order to maximize initial and sustained weight loss.