Obesity is a worldwide epidemic and represents a risk factor for Covid-19 infection. Therefore, the continuation of an effective treatment is needed even during this Covid-19 new phase, where the number of infections has decreased, but a vaccine is lacking and a new epidemic is expected. Bariatric surgery represents a gold standard treatment for morbid obesity in favoring a significant weight loss. Although, some patients experience insufficient weight loss after surgery. Previous studies showed that psychological factors may affect post-surgery weight loss and compliance to clinician's recommendation.
This study aims to test the efficacy of an online combined intervention, based on a psychological and nutritional treatment using telemedicine at the time of Covid-19. Telemedicine is strongly encouraged in order to reduce the number of hospital accesses and infections.
The protocol will be tested on 40 patients of the Bariatric Center of Excellence, "Sapienza" University of Rome. All participants included in the study will be randomly assigned to the following group: 1) usual scheduled treatment group (one - to -one sessions) vs 2) combined psychological and nutritional telematic treatment group (online sessions). Both groups will carry out scheduled post-operative sessions at 1, 3, 6 months consisting in monitoring weight, comorbidities trend, nutritional status, and post-surgical complications. The telematic treatment group will carry out an online psychological support and an intensive nutritional counseling.
Both groups will be evaluated 1 week before surgery (T0), and at 1 (T1), at 3 (T2), at 6 months (T3) after surgery. Finally,6 months after the combined psychological and nutritional treatment ending (T4).
We expect a reduction in psychopathological symptomatology, the achievement of a sufficient weight loss, higher compliance, psychological well being and quality of life in the combined psychological and nutritional telematic treatment group.
The innovation of the present study is that an on-line combined intervention based on a psychological support and an intensive nutritional counseling could favor sufficient weight loss in the short term period and eventually in the mid and long term period after surgery. If the hypotheses will be verified, this protocol could represent an online post-operative support model for clinicians in bariatric surgery to spend in the clinical practice. Moreover, the use of video-calls represents an alternative and innovative strategies. In fact, the on-line patients' management seems particularly interesting in this specific period where Covid-19 is still affecting people, and reducing the number of hospital accesses is recommended. Furthermore, such online model could prevent the long-term dispersion of patients, especially among those with difficulties in going to the healthcare facility (eg.lack of transportations, economic burden).