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However, it is currently unknown how Tele-CBT impacts outcomes long term, and if differences in weight loss trajectories following Tele-CBT emerge with a long-term follow-up. This study aimed to identify whether Tele-CBT remains effective at 18 months post-intervention for improving psychological distress and maladaptive eating, and mitigating recurrent weight gain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This large, multisite randomized control trial was conducted at three hospital-based MBS programs in Ontario, Canada. Participants (<jats:italic>n<\/jats:italic>\u2009=\u2009306) were randomized 1:1 to receive either Tele-CBT or standard MBS care. The primary outcome was percentage of total weight loss (%TWL). Secondary outcomes included disordered eating (Binge Eating Scale, Emotional Eating Scale) and psychological distress (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). Linear mixed models assessed group-by-time interactions across five time points: baseline (1-year post-MBS), post-intervention, and 3-, 12-, and 18-month follow-ups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Tele-CBT resulted in significant post-intervention improvements in binge eating (<jats:italic>MD<\/jats:italic>\u2009= \u2212\u20090.46, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), emotional eating (<jats:italic>MD<\/jats:italic>\u2009= \u2212\u20090.14, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), anxiety (<jats:italic>MD<\/jats:italic>\u2009= \u2212\u20090.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and depressive symptoms (<jats:italic>MD<\/jats:italic>\u2009= \u2212\u20090.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). These improvements were all sustained at 3 months post-intervention (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) whereas only improvements for emotional eating were sustained at 12 months post-intervention (<jats:italic>MD<\/jats:italic>\u2009= \u2212\u20090.15, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). There were no significant differences in %TWL trajectories between the Tele-CBT and control groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Tele-CBT provides psychological benefits, particularly in reducing emotional eating. Findings highlight the need for continued psychosocial support to sustain other psychological benefits and mitigate recurrent weight gain post-MBS and further research on optimizing intervention timing and duration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial Registration<\/jats:title>\n            <jats:p>\n              <jats:bold>ClinicalTrials.gov Identifier:<\/jats:bold> NCT03315247.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11695-025-08163-2","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T01:53:47Z","timestamp":1756691627000},"page":"4103-4113","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Randomized-Controlled Trial Examining Telephone-Based Cognitive Behavioral Therapy for Patients After Metabolic and Bariatric Surgery: 18 Month Follow-up Results"],"prefix":"10.1007","volume":"35","author":[{"given":"Stephanie E.","family":"Cassin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katey E.","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha E.","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Tomlinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Hawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Wnuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Urbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Okrainec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"Sandre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Sockalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"issue":"12","key":"8163_CR1","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1056\/NEJMoa1700459","volume":"377","author":"TD Adams","year":"2017","unstructured":"Adams TD, Davidson LE, Litwin SE, et al. 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