The goal of this interventional study is to evaluate the Treatment and Evaluation for After Metabolic Surgery with Eating Disorders (TEAM-ED) program, which combines streamlined access to screening, diagnostic assessment, and treatment with an interdisciplinary team approach to treatment planning, for managing disordered eating in adults who have recently had weight loss surgery in Nova Scotia. The main question it aims to answer is 'can an interdisciplinary program for identifying and managing disordered eating after weight loss surgery be implemented in Nova Scotia?
This study will determine the feasibility and impact of the TEAM-ED program by assessing the following objectives:
1. Reach (how effectively the program engages the target population \[post-weight loss surgery patients\]) 2. Effectiveness (the extent of the program's impact on key clinical outcomes related to disordered eating and weight management) 3. Adoption (the extent to which the program is adopted and accepted by clinicians) 4. Implementation (how consistent program delivery is and factors impacting consistent delivery)
Participants will complete a disordered eating screening questionnaire online every 3 months after weight loss surgery until they reach 18-months post-surgery. Participants found to have disordered eating will be referred to the Nova Scotia Provincial Eating Disorder Service (NSEDPS) for standard disordered eating treatment (brief cognitive behavioral therapy \[CBT-T\]) plus treatment plan oversight by both weight loss surgery and eating disorder specialists. Standard outcome measures will be collected at baseline, during eating disorder treatment, post-treatment, and at follow-ups. Participants may also be asked to do a one-on-one research interview about their experiences with the program.
≥19 years old
Between 3- and 18-months post-weight loss surgery.
Able to complete English computer-based self-report questionnaires (with adequate accommodation, if necessary).
None
Single group
Treatment and Evaluation for After Metabolic Surgery with Eating Disorders (TEAM-ED) Program
BehavioralA program that combines a) streamlined access to screening, diagnostic assessment, and treatment (brief cognitive behaviour therapy \[CBT-T\]), b) an interdisciplinary team approach to treatment planning, for managing disordered eating in patients post-weight loss surgery.
Screening Engagement Rate
Percentage of eligible patients (i.e., post-weight loss patients who are enrolled in the screening procedure) who complete the disordered eating screening measure (i.e., Loss of Control Over Eating Scale \[LOCES\]) at each timepoint (3-, 6-, 9-, 12-, 15-, and 18-month). To be calculated with the equation: \[Actual # of LOCES completed at a timepoint\] / \[Total # of eligible patients who could have completed LOCES at that timepoint\]
Screening Initiation Rate
Percentage of eligible patients (i.e., those who are 3- to 18-months post-weight loss surgery and receiving follow-up care at the study clinics) who initiate the screening procedure. This will be calculated using the equation: \[number of patients who fill out their initial screening questionnaire\] / \[number of patients registered for follow-up care post-weight loss surgery at the study clinics\]. \*Screening questionnaire is the Loss of Control Over Eating Scale (LOCES).
Proportion of eligible patients who screen positive for loss of control eating.
Proportion of eligible patients (i.e., those enrolled in the screening procedure) who are identified via screening questionnaire as having loss of control eating. This will be calculated using the equation: \[number of patients who screen positive for loss of control eating\] / \[number of patients enrolled in screening procedure\]. \*Screening questionnaire is the Loss of Control Over Eating Scale (LOCES).
Proportion of eligible patients who undergo a disordered eating diagnostic interview.
Proportion of eligible patients (i.e., those who screen positive for disordered eating) who complete a disordered eating diagnostic interview led by a clinician using the Eating Disorder Examination - Bariatric Surgery Version (EDE-BSV).
Proportion of eligible patients who are diagnosed with disordered eating.
Proportion of eligible patients (i.e., those in the screening procedure who screen positive then attend a disordered eating diagnostic interview) who are diagnosed with disordered eating by the clinician conducting the interview based on the results of that assessment.
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Aaron Keshen
Lead sponsor
Nova Scotia Health Authority
Sponsor institution
Queen Elizabeth II Health Sciences Centre Foundation
Collaborator
