Effect of obesity treatments on eating behavior: psychosocial interventions versus surgical interventions. A systematic review.

OBJECTIVE

(1) To use available research data to estimate the amount of change in eating behavior following obesity treatment; (2) To examine how this change relates to the amount of change in weight loss after treatment and at follow up. A meta-analysis was conducted in September 2009.

METHODS

Studies were identified through a computer search of articles in the PubMed and PsychInfo databases. Key terms entered were obesity, treatment, and eating behavior. Effect sizes (Glass d) were calculated according to published procedures.

RESULTS

Eighteen studies met the inclusion and exclusion criteria, grouped into two categories: psychosocial interventions and surgical interventions. For psychosocial interventions, we found a medium effect size on eating behavior (d=.73, CI=(.66, .90)), and a low effect size on weight (d=.32, CI=(.28, .36)) at posttreatment and a low effect size for both outcomes at follow-up (for eating behavior d=.47, CI=(.45, .49), for weight d=.37, (CI=.18, .56)). For surgical interventions we found large effect sizes on both outcomes (for eating behavior d=1.84, CI=(1.26, 2.42); for weight d=1.40, CI=(1.25, 1.65)).

CONCLUSIONS

Surgical interventions have superior results to psychosocial interventions, on both weight loss and eating behavior. Implications for treatment of obesity are discussed.