JMIR Publications

ABSTRACT

Background:

Physical activity levels after bariatric surgery are usually low, despite the significant protective health benefits of physical activity in this population. Positive psychological well-being is associated with improved adherence to health behaviors, but bariatric surgery patients often have negative associations with physical activity that prevent sustained engagement.

Objective:

The Gaining Optimism After weight Loss Surgery (GOALS) randomized controlled pilot trial will test a novel intervention to increase physical activity after bariatric surgery that incorporates positive psychological skill-building with motivational interviewing and goal-setting.

Methods:

The GOALS trial is a two-arm, 24-week randomized controlled pilot trial that will aim to enroll 58 adults who report low physical activity and a desire to get more active 6-12 months after bariatric surgery. GOALS will test the feasibility, acceptability, and preliminary efficacy of a positive psychology-motivational interviewing telephone intervention targeting increased physical activity and associated positive affect. Intervention components will include positive psychology, goal-setting, self-monitoring via provided Fitbits, and motivational interviewing to overcome barriers and increase motivation. The primary outcomes of the pilot trial are feasibility and acceptability, measured as session completion rates and participant ratings of ease and helpfulness of each session. The main secondary outcome is change in accelerometer-measured moderate-to-vigorous physical activity at 10 weeks.

Results:

This multiphase project was funded in 2020 and Institutional Review Board approval was obtained for the proposed trial in 2021. Recruitment for the randomized controlled trial begins in July 2022. Upon completion of the pilot trial, we will examine feasibility, acceptability, and preliminary efficacy of the intervention.

Conclusions:

Although bariatric surgery is the most effective treatment available for severe obesity, weight regain occurs, often in the context of low psychological well-being. Many individuals who are post-bariatric surgery would benefit from learning strategies to increase positive psychological well-being that could help them maintain lifestyle changes. Positive psychology is a novel approach to improve adherence by increasing positive associations with health behaviors like physical activity. The GOALS pilot trial will determine whether this type of intervention is feasible and acceptable to patients, and will provide a foundation for a future full-scale randomized controlled efficacy trial. Clinical Trial: NCT04868032