Systematic Review of Mindfulness-Based Interventions for Weight Management Among Pre- and Post-bariatric Surgery Patients

Yara Almuhtadi, PhD; Samah Alageel, MPH, PhD



Context • Bariatric surgery has been an effective treatment for severe obesity. However, it can be challenging for bariatric-surgery patients to reach and maintain long-term weight loss. Behavioral interventions may be beneficial in reducing weight and improving the psychological outcomes of bariatric patients.

Objective • The review intended to evaluate the benefits of mindfulness training for weight management among pre- and postoperative, bariatric-surgery patients and to help determine the design of the most effective mindfulness program for them.

Design • The research team performed a systematic narrative review by searching the Medline, Excerpta Medica Database (EMBASE), PsycINFO, Web of Knowledge, PubMed, and CENTRAL databases. The search terms included mindfulness-based therapy, stress reduction, relaxation therapy, meditation, and acceptance and commitment therapy. Eligible studies included those using interventions that examined the impact of mindfulness on weight loss for bariatric-surgery patients. Due to the heterogeneity of the included studies, the research team conducted a narrative synthesis rather than a meta-analysis.

Setting • The review took place in the Community Health Sciences Department at the College of Applied Medical Sciences of King Saud University in Riyadh, Kingdom of Saudi Arabia.

Outcome Measures • Primary outcomes included indicators of body-weight change, such as kilograms, pounds, or BMIs. Secondary outcomes included changes: (1) in eating behavior, such as in binge eating, grazing behavior, craving behavior, and emotional eating, (2) in caloric intake, (3) in mental health, including a reduction in anxiety or depression, (4) in quality of life, (5) mindfulness acceptability and practice, (6) in physical activity, and (7) in glycated hemoglobin (HbA1c).

Results • The research team included eight studies in the review. One study aimed to explore the impact of mindfulness on pre-operative patients, and the remaining seven studies measured the impact among postoperative individuals. Most studies suggested that mindfulness-based interventions can have a positive impact on weight outcomes and eating behaviors. The team also found promising effects for mental health outcomes, including anxiety and depression. It’s important to note that the included studies reported no strategies that examined treatment fidelity and the monitoring of an intervention’s delivery.

Conclusions • Preliminary results suggest that mindfulness-based interventions can be useful in tackling eating disorders and in promoting weight loss among bariatric individuals. Further studies are warranted in this area to make explicit recommendations that inform pre- and post-bariatric guidelines. The field needs further well-developed studies to understand the impact of mindfulness on weight loss in the long term. (Adv Mind Body Med. 2023;37(3):15-22.)



Yara Almuhtadi, PhD, Assistant Professor of Nutrition and Behavior change, and Samah Alageel, MPH, PhD, Assistant Professor of Epidemiology and Public health, Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.

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