CASE SERIES STUDY ON MENTALIZATION-BASED GROUP THERAPY FOR ADULTS WITH OBESITY FOLLOWING BARIATRIC SURGERY.

Abstract

Background: Obesity is a multifaceted condition with biological, psychological, and social determinants. Despite the effectiveness of bariatric surgery for severe obesity, long-term outcomes often depend on the patient's psychological adjustment and capacity for behavioral change. Emerging evidence suggests that mentalization, i.e., the ability to understand behavior in terms of mental states, may play a key role in sustaining these changes. To explore the effects of a group intervention on psychological functioning, reflective function, and health-related behaviors in individuals following bariatric surgery.

Methods: This multiple case study involved five cisgender women with class I obesity post-bariatric surgery referral. Three participants completed a six-month MBT group intervention. Assessments included the CORE-OM, the RFQ, and open-ended experiential questions administered pre- and post-intervention. Quantitative data were analyzed using descriptive and visual methods; qualitative data were analyzed with lexical co-occurrence analysis using T-LAB software.

Results: Quantitative results indicated improvements in psychological symptoms, well-being, and reflective functioning. RFQ scores reflected reduced hypomentalization and hypermentalization. Lexical analysis revealed a thematic shift from concrete concerns with body weight and dietary control to more relational, emotionally nuanced, and self-reflective language. Participants reported increased emotional regulation, improved interpersonal functioning, and greater insight into their health-related behaviors.

Conclusions: MBT may enhance post-surgical adjustment by fostering reflective capacity and emotional awareness in individuals with obesity. These findings support the integration of mentalization-focused approaches in obesity treatment to address the psychological complexities underlying health behavior change.