Understanding the Components of Eating Behaviour-Focused Weight Management Interventions Adjunct to Metabolic Bariatric Surgery: Systematic Review of Published Literature

Eating behaviour-focused interventions are essential for improving health and weight-related outcomes in patients undergoing metabolic bariatric surgery (MBS). This work aims to examine the content of eating behaviour-focused weight management interventions adjunct to MBS in terms of the type and quantity of behaviour change techniques (BCTs). A literature search retrieved randomised controlled and parallel group trials up to March 2024. A total of 25 trials were included in the final analysis. Trained coders used Michie’s BCT taxonomy v1.0 to code intervention components from each trial and applied descriptive methods to report the types and frequency of BCTs. Calculated effect sizes were used to compare the impact of the experimental and comparator arms. Common BCTs applied in eating behaviour-focused interventions were ‘4.1 Instruction on how to perform a behaviour’ (68%), ‘2.3 Self-monitoring of behaviour’ (56%), ‘1.1 Goal setting (behaviour)’ (52%), ‘1.2 Problem solving’ (44%), ‘3.1 Social support (unspecified)’ (40%), and ‘1.4 Action planning’ (40%). However, the BCTs associated with the largest intervention effect sizes (2.1. Monitoring of behaviour by others without feedback and 4.2. Information about antecedents) were not among the most frequently employed techniques. Only one study described the intervention explicitly using BCT taxonomy groupings. In more than half of the studies (52%), authors did not use BCTs to describe interventions. This work highlights the importance of using standard frameworks for reporting the components of behavioural interventions to enhance scientific replication, evidence synthesis, and the ability to test interventions’ effectiveness in the future.