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Barnhart WR, Kalantzis M, Gaggiano C, Braden AL. The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research. Appetite 2024; 198:107343. [PMID: 38604382 DOI: 10.1016/j.appet.2024.107343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/15/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
| | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Christina Gaggiano
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
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Büyükkasap Ç. Assessing how bariatric surgery, emotional eating, and depression could affect each other: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36409. [PMID: 38050210 PMCID: PMC10695543 DOI: 10.1097/md.0000000000036409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
Emotional eating (EE) has been found to be associated with depression, anxiety, excessive weight, obesity, and unhealthy eating habits. EE could also be associated with recurrent weight gain. To date, the factors predicting success following bariatric surgery remain uncertain. In addition, there is a paucity of data regarding the associations between EE, percent of total weight loss (TWL), and depression after bariatric surgery. The aims of this study were to evaluate the relationship between EE behavior, depression, and TWL, and to identify other factors, such as the type of bariatric surgery, that may have an impact on EE, depression and TWL after bariatric surgery. A self-report questionnaire was administered to 253 patients who underwent bariatric surgery between 2014 and 2021 at the Department of General Surgery, Faculty of Medicine, Gazi University. In total, 115 patients agreed to participate and completed the questionnaire. The administered scales consisted of the Sociodemographic Data Form, Emotional Eating Scale (EES), and Beck Depression Inventory (BDI). The participants were divided into the Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) groups. The RYGB and SG groups included 79 (68.8%) and 36 (31.3%) patients, respectively. A significant difference was found in terms of age (P = .002) and gender (P = .033). The BDI scores (P = .499) and TWL (P = .068) did not differ significantly. The EES score was higher in the SG group (P = .020). Between the groups with and without EE, age (P = .004) and BDI scores (P = .004) were significantly different. In correlation analyses, EES score was related to BDI score(ρ = 0.402, P < .001) and age(ρ = -0.348, P = .002) in the RYGB group. In regression analyses, TWL was associated with age (β = -0.366, P < .001) and surgery type (β = -6.740, P < .001), EES score was associated with BDI score (β = 0.149, P = .009) and age (β = -0.154, P = .006), and BDI score was associated with EES score (β = 0.419, P = .009) and age (β = -195, P = .041). In patients with moderate-to-severe depression, TWL was higher than in those without depression (P = .025). The effect of emotional eating and depression on TWL was not detected. Emotional eating and depression trigger each other in the individuals who underwent bariatric surgery. Young individuals who undergo bariatric surgery are more vulnerable to emotional eating and depression than older patients.
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Affiliation(s)
- Çağri Büyükkasap
- Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Turkey
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Sobhani Z, Hosseini SV, Honarparvaran N, Khazraei H, Amini M, Hedayati A. The effectiveness of an online video-based group schema therapy in improvement of the cognitive emotion regulation strategies in women who have undergone bariatric surgery. BMC Surg 2023; 23:98. [PMID: 37106316 PMCID: PMC10134519 DOI: 10.1186/s12893-023-02010-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Adaptive cognitive emotion regulation (CER) strategies toward eating play a very important role in obesity and according to schema therapy, patients with obesity learn that don't respond to their emotional stimuli by eating. Thus, this study aimed to evaluate the effectiveness of an online video-based group schema therapy in improvement of the CER strategies and body mass index (BMI) in women who had undergone bariatric surgery. METHODS Forty women who had undergone sleeve gastrectomy were selected and randomly divided into two groups of control and experimental. The experimental group received 10 weekly 90-min sessions of group schema therapy, the control group did not receive any intervention at all. Both groups completed the CER strategies questionnaire during pre-test, post-test and follow-up stages, and the data were analyzed using a multivariate analysis of covariance (MANCOVA) through SPSS software (version 20). RESULTS Our results indicated that the experimental group demonstrated significantly higher adaptive CER strategies (P = 0.0001, F = 31.15) and significantly lower maladaptive CER strategies (P = 0.001, F = 9.42), significantly lower BMI (P = 0.001, F = 23.48), as compared to the control condition, following the group schema therapy after the follow-up stage. CONCLUSION The findings demonstrated that group schema therapy could lead to an increases in adaptive CER strategies and a decrease in maladaptive CER strategies and BMI in women who had undergone bariatric surgery. TRIAL REGISTRATION IRCT, IRCT20180523039802N2. Registered 5 August 2020, http://www.irct.com/IRCT20180523039802N2 .
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Affiliation(s)
- Zahra Sobhani
- Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Vahid Hosseini
- Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nazanin Honarparvaran
- Department of counselling, Marvdash Branch, Islamic Azad University, Marvdasht, Iran
| | - Hajar Khazraei
- Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masood Amini
- Laparoscopy research center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arvin Hedayati
- Research Center for Psychiatry and behavior Science , Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
Food addiction is associated with dysfunctions in the reward circuit, such as hyperresponsiveness during the exposure to high-calorie flavors in overweight and obese individuals. Similar to drug addiction, there is also impaired self-regulatory control supported by deregulation of the frontostriatal circuit. The inclusion of validated measures of food addiction in clinical research, such as the Yale Food Addiction Scale, has increased the understanding of the clinical utility of this concept. Furthermore, food addiction, eating disorders, and obesity are interrelated. Thus, it is important to recognize food addiction among individuals affected by obesity and candidates for bariatric surgery (ie, preoperative and postoperative assessment). In this context, it has been reported that food addiction may impede weight loss and increase the likelihood of regaining weight when associated with personality traits such as neuroticism and impulsiveness, which are also related to mood disorders, anxiety, and addictive behaviors.
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All in the Family: Child and Adolescent Weight Loss Surgery in the Context of Parental Weight Loss Surgery. CHILDREN 2021; 8:children8110990. [PMID: 34828703 PMCID: PMC8620201 DOI: 10.3390/children8110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 12/05/2022]
Abstract
Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their surgical status as having had surgery or not. Results: There were no differences in perceived family support, emotional eating, or food addiction symptoms between those whose parents had bariatric surgery and those whose parents did not. There were some moderating effects of parent surgery status on the relationship between social support, emotional eating/food addiction, and weight loss following surgery. Specifically, at 3 months post-surgery, higher change in BMI was associated with lower perceived family support only in those whose parents had not had surgery. More pre-surgical food addiction symptoms were associated with greater weight loss at 3 months for those whose parents had not had surgery, whereas this finding was true only for those whose parents had surgery at 12 months post-surgery. Conclusions: Children and adolescents whose parents have had bariatric surgery may have unique associations of psychosocial factors and weight loss. More research is needed to determine mechanisms of these relationships.
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Stammers L, Wong L, Churilov L, Price S, Ekinci E, Sumithran P. Comparison of two questionnaires for assessment of emotional eating in people undergoing treatment for obesity. Eat Weight Disord 2021; 26:2353-2360. [PMID: 33392954 DOI: 10.1007/s40519-020-01084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Emotional eating may contribute to weight gain and difficulty with weight loss. Questionnaires are currently the primary method used to identify this behaviour but there is no gold standard for detecting emotional eating, making it difficult to know which questionnaire to use for this purpose. This study assesses two questionnaires validated for assessment of emotional eating in patients with obesity, with the aim of investigating their interchangeability in the clinical setting. METHODS 387 adult participants were recruited from the obesity treatment service at a tertiary metropolitan hospital. Responses were obtained for the 25-item Emotional Eating Scale (EES) and the 4-item coping subscale of the Palatable Eating Motives Scale (PEMS). Agreement was analysed using quadratically weighted Cohen's κ scores. Substantial agreement was defined as κ 0.61-0.80. RESULTS The median (interquartile range) body mass index and age of participants was 42.1 kg/m2 (36.4-48.9 kg/m2) and 51.6 years (41.1-61.4 years), respectively, and 70.5% of participants were female. The EES and PEMS were found to have substantial agreement (κ 0.71; 95% CI 0.65-0.76). Agreement remained substantial when analysing responses from men (0.61; 95% CI 0.47-0.73), women (0.73; 95% CI 0.67-0.79) and post-bariatric surgery patients (0.72; 95% CI 0.62-0.82) separately. CONCLUSION Despite focusing on different elements of emotional eating behaviour, the substantial agreement between the EES and PEMS coping subscale suggests that they identify respondents' susceptibility to emotional eating with consistency, including in people who have undergone bariatric surgery. LEVEL V Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees. CLINICAL TRIAL REGISTRATION This observational study has not been registered as a clinical trial.
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Affiliation(s)
- Lauren Stammers
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia.,Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
| | - Lisa Wong
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia.,Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
| | - Leonid Churilov
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia
| | - Sarah Price
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia
| | - Elif Ekinci
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia.,Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia
| | - Priya Sumithran
- Department of Medicine (Austin Health), University of Melbourne, 145 Studley Road, Heidelberg, VIC, Australia. .,Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, VIC, 3081, Australia.
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7
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Jordan AK, Barnhart WR, Studer-Perez EI, Kalantzis MA, Hamilton L, Musher-Eizenman DR. 'Quarantine 15': Pre-registered findings on stress and concern about weight gain before/during COVID-19 in relation to caregivers' eating pathology. Appetite 2021; 166:105580. [PMID: 34186158 DOI: 10.1016/j.appet.2021.105580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/19/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
The coronavirus disease (COVID-19) has dramatically altered daily activities including eating and physical activity behaviors, which in turn may be related to eating pathology. Those who care for children (henceforth caregivers) may face the brunt of these changes, but little research has examined the consequences of COVID-19 on eating pathology in caregivers. A community sample of caregivers (N = 140) completed a cross-sectional online survey assessing demographics, stress and concern about weight gain before/during COVID-19, disordered eating (Eating Disorder Examination Questionnaire-Short Form), and emotional eating (Emotional Eating Scale-Revised). Significant positive relationships emerged between stress and concern about weight gain before/during COVID-19 and disordered eating, emotional eating-depression, emotional eating-anger/anxiety, and emotional eating-boredom. Stress and concern about weight gain during, but not before, COVID-19 positively predicted variance in disordered eating and emotional eating. Stress was associated with lower emotional eating-boredom when concern about weight gain during COVID-19 was low. Stress was associated with lower emotional eating-depression when concern about weight gain before COVID-19 was low, but when high, stress was associated with higher emotional eating-depression. Stress and concern about weight gain before/during COVID-19 may be relevant to worsened disordered eating and emotional eating in caregivers, a neglected population in the literature. Targeting concern about weight gain may weaken the relationship between stress and emotional eating-depression and emotional eating-boredom among caregivers in the context of the COVID-19 pandemic.
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Affiliation(s)
- Amy K Jordan
- Department of Psychology, Bowling Green State University, USA.
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Ivezaj V, Carr MM, Brode C, Devlin M, Heinberg LJ, Kalarchian MA, Sysko R, Williams-Kerver G, Mitchell JE. Disordered eating following bariatric surgery: a review of measurement and conceptual considerations. Surg Obes Relat Dis 2021; 17:1510-1520. [PMID: 34083136 DOI: 10.1016/j.soard.2021.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 02/24/2021] [Accepted: 03/13/2021] [Indexed: 11/18/2022]
Abstract
Eating disorders are associated with significant medical morbidity and mortality and serious psychological impairment. Individuals seeking bariatric surgery represent a high-risk group for evidencing disordered eating and eating disorders, with some patients experiencing the persistence or onset of disordered eating postsurgery. This review synthesizes the available literature on problematic or disordered eating in the bariatric field, followed by a review of measurement and conceptual considerations related to the use of eating disorder assessment tools within the bariatric population.
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Affiliation(s)
| | - Meagan M Carr
- Yale University School of Medicine, New Haven, Connecticut
| | - Cassie Brode
- West Virginia University School of Medicine, West Virginia
| | - Michael Devlin
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York; New York State Psychiatric Institute, New York, New York
| | | | | | - Robyn Sysko
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - James E Mitchell
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity. Eat Weight Disord 2020; 25:1621-1629. [PMID: 31728923 DOI: 10.1007/s40519-019-00800-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/17/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE After bariatric surgery (BS) a significant minority of patients do not reach successful weight loss or tend to regain weight. In recent years, interest for the psychological factors that predict post-surgical weight loss has increased with the objective of developing interventions aimed to ameliorate post-surgical outcomes. In the present study, predictive models of successful or poor weight loss 12 months after BS were investigated considering pre-surgery level of psychopathological symptoms, dysfunctional eating behaviors and trait impulsivity at baseline (pre-surgery). METHODS Sixty-nine patients with morbid obesity canditates for laparoscopic sleeve gastrectomy were assessed regarding metabolic and psychological dimensions. Successful post-surgery weight loss was defined as losing at least 50% of excess body weight (%EWL). RESULTS Logistic models adjusted for patient sex, age and presence of metabolic diseases showed that the baseline presence of intense psychopathological symptoms and low attentional impulsivity predict poor %EWL (< 50%), as assessed 12-month post-surgery. CONCLUSIONS The present findings suggest that intensity of general psychopathology and impulsivity, among other psychological factors, might affect post-surgery %EWL. Conducting adequate psychological assessment at baseline of patients candidates for BS seems to be crucial to orient specific therapeutic interventions. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Barnhart WR, Braden AL, Price E. Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study. Appetite 2020; 158:105038. [PMID: 33186623 DOI: 10.1016/j.appet.2020.105038] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/20/2020] [Accepted: 11/04/2020] [Indexed: 12/30/2022]
Abstract
Disordered eating includes core eating disorder symptoms present in diverse populations. The extant literature has focused on associations between negative emotional eating and disordered eating to the exclusion of positive emotional eating. Emotion regulation may help explain relationships between emotional eating and disordered eating. Emotion regulation difficulties was examined as a moderator of relationships between negative and positive emotional eating and disordered eating including dietary restraint, eating, weight, and shape concerns, and global scores of disordered eating, a general index of disordered eating. A cross-sectional study was employed using a university student population in the United States. Participants completed surveys assessing negative (Dutch Eating Behavior Questionnaire; Emotional Appetite Questionnaire) and positive (Emotional Appetite Questionnaire) emotional eating, emotion regulation (Difficulties in Emotion Regulation Scale), and disordered eating (Eating Disorder Examination Questionnaire). Moderation analyses were calculated with emotion regulation difficulties as the moderator of relationships between negative and positive emotional eating and disordered eating. Across two separate measures of negative emotional eating, higher negative emotional eating was associated with higher weight concerns and global scores of disordered eating when emotion regulation difficulties was average and increased (+1 SD above average). Higher positive emotional eating was associated with lower dietary restraint and global scores of disordered eating when emotion regulation difficulties was decreased (-1 SD below average). Emotion regulation difficulties strengthened relationships between negative, not positive, emotional eating and disordered eating. Research and clinical implications for the contribution of emotional eating and emotion regulation on disordered eating were discussed.
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Affiliation(s)
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, USA
| | - Ellysia Price
- Department of Psychology, Bowling Green State University, USA
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Stammers L, Wong L, Brown R, Price S, Ekinci E, Sumithran P. Identifying stress-related eating in behavioural research: A review. Horm Behav 2020; 124:104752. [PMID: 32305343 DOI: 10.1016/j.yhbeh.2020.104752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 03/26/2020] [Accepted: 04/07/2020] [Indexed: 11/29/2022]
Abstract
Stress is a commonly reported precipitant of overeating. Understanding the relationship between stress and food intake is important, particularly in view of the increasing prevalence of obesity. The purpose of this review is to examine how stress-related eating has been defined and measured in the literature to date. There are no established diagnostic criteria or gold standards for quantification of stress-related eating. Questionnaires relying on the accuracy of self-report are the mainstay of identifying people who tend to eat in response to stress and emotions. There is a paucity of clinical research linking objective measurements of stress and appetite with self-reported eating behaviour. Limitations of the methodological approaches used and the heterogeneity between studies leave significant knowledge gaps in our understanding of the mechanism of stress related eating, and how best to identify it. These issues are discussed, and areas for further research are explored.
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Affiliation(s)
- Lauren Stammers
- Department of Medicine (Austin), University of Melbourne, 145 Studley Road, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia.
| | - Lisa Wong
- Department of Medicine (Austin), University of Melbourne, 145 Studley Road, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia.
| | - Robyn Brown
- Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, University of Melbourne, Parkville, Victoria, Australia.
| | - Sarah Price
- Department of Medicine (Austin), University of Melbourne, 145 Studley Road, Heidelberg, Victoria, Australia.
| | - Elif Ekinci
- Department of Medicine (Austin), University of Melbourne, 145 Studley Road, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia.
| | - Priya Sumithran
- Department of Medicine (Austin), University of Melbourne, 145 Studley Road, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia.
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12
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Barnhart WR, Braden AL, Jordan AK. Negative and positive emotional eating uniquely interact with ease of activation, intensity, and duration of emotional reactivity to predict increased binge eating. Appetite 2020; 151:104688. [DOI: 10.1016/j.appet.2020.104688] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 12/12/2022]
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13
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Wong L, Stammers L, Churilov L, Price S, Ekinci E, Sumithran P. Emotional eating in patients attending a specialist obesity treatment service. Appetite 2020; 151:104708. [PMID: 32283188 DOI: 10.1016/j.appet.2020.104708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The prevalence of emotional eating (EE) has increased in the general population over past decades. There is limited information on how common EE is among people seeking obesity treatment. We aimed to estimate the proportion of people with EE, and strength of associations between a predefined set of factors and EE in people referred for obesity treatment. METHODS Cross-sectional study recruiting 387 adults from a hospital obesity service. "Emotional eating" was defined as Emotional Eating Scale (EES) score ≥25. Strength of associations were estimated by boot-strapped quantile regression analysis. Results are presented as quantile difference (QD) of EES scores at the 25th, 50th or 75th quantile, and 95% confidence intervals (95%CI). RESULTS The study population consisted of 71% women, with a median age of 52 years (interquartile range [IQR]: 42, 61), and a median body mass index of 42 kg/m2 (IQR: 37, 49). 187 participants were managed with lifestyle modification alone, 103 with the addition of obesity pharmacotherapy, 79 with bariatric surgery, and 18 with both bariatric surgery and medications. EE was reported by an estimated 58% (95%CI: 53, 63) of participants. Factors with the largest and most consistent magnitude of association with EES differences include age, sex, use of glucagon-like peptide-1 (GLP-1) agonists, history of sleeve gastrectomy and recent bariatric surgery. CONCLUSION Emotional eating affected more than half of people referred for obesity treatment. Age, sex, use of GLP-1 agonists, history of sleeve gastrectomy and recent bariatric surgery had the strongest associations with EE. These findings allow hypothesis generation about the underlying physiological mechanisms behind emotional eating for investigation in future research.
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Affiliation(s)
- Lisa Wong
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren Stammers
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia
| | - Leonid Churilov
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Price
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia
| | - Elif Ekinci
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia; Dept of Endocrinology, Austin Health, Melbourne, Victoria, Australia
| | - Priya Sumithran
- Department of Medicine (Austin), University of Melbourne, Melbourne, Victoria, Australia; Dept of Endocrinology, Austin Health, Melbourne, Victoria, Australia.
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14
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Stapleton P, Spinks T, Carter B. Psychological Determinants of Continued Obesity One-Year Postbariatric Surgery. Psychol Rep 2020; 123:1044-1063. [PMID: 32659202 DOI: 10.1177/0033294119844983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Bariatric surgery is an effective treatment for obesity; however, an estimated 20% of patients do not experience significant weight loss postsurgery. This study examined the interaction of potential psychological factors and their mediating effects on the emotional eating of individuals one-year postbariatric surgery. METHOD Three-hundred and sixty-six obese individuals (348 females; 95.1%) with a body mass index greater than 30 kg/m2 (M = 39.14; SD = 7.67) completed the Patient Health Questionnaire, the Brief Cope, the Big-Five Mini-Marker of Personality, and the Three-Factor Eating Questionnaire R-18. RESULTS The variance accounted for in emotional eating by age and 12 psychological factors were assessed via a four-step hierarchical multiple regression. Avoidant coping and the personality traits of extraversion, agreeableness, and in contrast to that hypothesized, emotional stability were significant predictors of emotional eating. Avoidant coping partially mediated the relationships of extraversion and emotional stability with emotional eating and fully mediated the relationship of agreeableness. CONCLUSION Certain personality traits may influence the preferred coping style chosen by individuals who experience continued obesity after bariatric surgery. Additional supports and tailored interventions that are matched with the needs of this population may subsequently be necessary to overcome emotional eating and improve weight loss.
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Affiliation(s)
- Peta Stapleton
- School of Psychology, Bond University, Queensland, Australia
| | - Teagan Spinks
- School of Psychology, Bond University, Queensland, Australia
| | - Brett Carter
- School of Psychology, Bond University, Queensland, Australia
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15
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Conceição EM, Fernandes M, de Lourdes M, Pinto-Bastos A, Vaz AR, Ramalho S. Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eat Weight Disord 2020; 25:679-692. [PMID: 30859467 DOI: 10.1007/s40519-019-00671-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Engaging in a healthy lifestyle after bariatric surgery is essential to optimize and sustain weight loss in the long term. There is promising evidence that social support of patients who undergo bariatric surgery plays an important role in promoting a better quality of life and adherence to the required behavioral changes and medical appointments. This study sought to investigate: (a) if post-operative patients experience different levels of perceived social support compared to pre-operative patients; (b) correlations between perceived social support, depression, disordered eating, and weight outcomes; (c) if social support is a moderator between psychological distress, and disordered eating behavior and weight outcomes. METHODS A group of 65 patients assessed pre-surgery and another group of 65 patients assessed post-surgery (M = 26.12; SD 7.97 months since surgery) responded to a set of self-report measures assessing social support, eating disorder psychopathology, disordered eating, and depression. RESULTS Greater social support was associated with lower depression, emotional eating, weight and shape concerns, and greater weight loss in pre- and post-surgery groups. Social support was found to be a moderator between different psychological/weight variables but only for the post-surgery group: the relation between depression and eating disorder psychopathology or weight loss was significant for patients scoring medium to high level is social support; the relation between grazing and weight regain was significant for patients scoring medium to low levels of social support. CONCLUSIONS The associations found between perceived social support and depression, disordered eating and weight outcomes highlight the importance of considering and working with the social support network of patients undergoing bariatric surgery to optimize treatment outcomes. Level of Evidence Level III: case-control study.
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Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal.
| | - Marta Fernandes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
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16
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Hindle A, De la Piedad Garcia X, Hayden M, O'Brien PE, Brennan L. Pre-operative Restraint and Post-operative Hunger, Disinhibition and Emotional Eating Predict Weight Loss at 2 Years Post-laparoscopic Adjustable Gastric Banding. Obes Surg 2020; 30:1347-1359. [PMID: 32006239 DOI: 10.1007/s11695-019-04274-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION A principal mechanism of action in bariatric surgery is reduction in calorie consumption due to decreased hunger and increased satiety. Patients' ability to perceive post-operative changes to their hunger is therefore central to optimal results. This study examined factors that may impact how patients perceive post-operative hunger and how perception of hunger impacts eating and subsequent weight loss after laparoscopic adjustable gastric banding (LAGB). METHODS Patients undertaking LAGB (n = 147) provided pre-surgery and 2-year weight loss data and pre-surgery and 12-month psychological data (perception of hunger, disinhibition related to eating, emotional eating). RESULTS Path analysis demonstrated that patients with lower levels of pre-surgery cognitive restraint over eating experienced significantly greater reduction in perception of hunger at 12 months post-surgery. Perceived reduction in hunger was significantly associated with lower levels of both emotional eating and disinhibited eating. Finally, reduced emotional eating at 12 months significantly predicted 9% of the variance in percentage of total weight loss (%TWL) at 2 years after surgery. CONCLUSION These initial findings suggest that preparation for bariatric surgery may be enhanced by psychoeducation regarding cognitive restraint over eating and its effect on hunger perception. In addition, psychological treatment that focuses on identifying and responding to changes in hunger may contribute to improved outcomes for those who have difficulty adjusting to post-operative eating behaviours.
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Affiliation(s)
- Annemarie Hindle
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia. .,Centre for Eating, Weight, and Body Image, Suite 215, 100 Victoria Parade, East, Melbourne, Victoria, 3002, Australia.
| | - Xochitl De la Piedad Garcia
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia
| | - Melissa Hayden
- Faculty of Health, Deakin University Burwood Melbourne Campus, 221 Burwood Highway, Burwood, 3125, Australia
| | - Paul E O'Brien
- Centre for Obesity Research and Education, The Alfred Centre, Monash University Clinical School, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Leah Brennan
- Centre for Eating, Weight, and Body Image, Suite 215, 100 Victoria Parade, East, Melbourne, Victoria, 3002, Australia.,School of Psychology and Public Health, La Trobe University, Albury-Wodonga Campus, 133 McKoy Street, 3689, Wodonga, Victoria, Australia
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17
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Prospective Study of Attachment as a Predictor of Binge Eating, Emotional Eating and Weight Loss Two Years after Bariatric Surgery. Nutrients 2019; 11:nu11071625. [PMID: 31319502 PMCID: PMC6683092 DOI: 10.3390/nu11071625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022] Open
Abstract
Bariatric surgery remains the most effective treatment for severe obesity, though post-surgical outcomes are variable with respect to long-term weight loss and eating-related psychopathology. Attachment style is an important variable affecting eating psychopathology among individuals with obesity. To date, studies examining eating psychopathology and attachment style in bariatric surgery populations have been limited to pre-surgery samples and cross-sectional study design. The current prospective study sought to determine whether attachment insecurity is associated with binge eating, emotional eating, and weight loss outcomes at 2-years post-surgery. Patients (n = 108) completed questionnaires on attachment style (ECR-16), binge eating (BES), emotional eating (EES), depression (PHQ-9), and anxiety (GAD-7). Multivariate linear regression analyses were conducted to examine the association between attachment insecurity and 2-years post-surgery disordered eating and percent total weight loss. Female gender was found to be a significant predictor of binge eating (p = 0.007) and emotional eating (p = 0.023) at 2-years post-surgery. Avoidant attachment (p = 0.009) was also found to be a significant predictor of binge eating at 2-years post-surgery. To our knowledge, this study is the first to explore attachment style as a predictor of long-term post-operative eating pathology and weight outcomes in bariatric surgery patients.
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18
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Wiedemann AA, Ivezaj V, Grilo C. An examination of emotional and loss-of-control eating after sleeve gastrectomy surgery. Eat Behav 2018; 31:48-52. [PMID: 30118925 PMCID: PMC6247803 DOI: 10.1016/j.eatbeh.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 01/21/2023]
Abstract
Emotional eating has been identified as a predictor of poorer weight loss outcomes in non-bariatric clinical samples. It is unknown, however, whether emotional eating contributes to poorer weight loss outcomes after bariatric surgery or how it might be associated with loss-of-control (LOC) eating, a known predictor of post-surgical outcomes. This study examined the nature and significance of emotional eating among post-bariatric surgery patients with LOC eating. Participants (N = 134) were patients with LOC eating (at least once weekly) seeking treatment to help improve eating approximately 4-9 months following sleeve gastrectomy surgery. Participants were assessed with the Eating Disorder Examination-Bariatric Surgery Version interview, Yale Emotional Overeating Questionnaire, and Beck Depression Inventory-II. Emotional eating and LOC eating were significantly negatively correlated with post-surgical weight loss (p's < 0.05), both variables had a small effect. Linear regression analyses revealed that both emotional eating and frequency of LOC eating were independently associated with weight loss (R2 = 0.041 and 0.049, respectively). Our findings suggest that, among post-sleeve gastrectomy patients with LOC eating, greater frequency of LOC eating and LOC eating in response to emotions are associated with poorer weight outcomes.
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Affiliation(s)
| | | | - Carlos Grilo
- Yale School of Medicine, Psychiatry Department, New Haven, CT,Yale University, Department of Psychology, New Haven, CT
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19
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Examination of the Effectiveness of a Brief, Adapted Dialectical Behavior Therapy-Skills Training Group for Bariatric Surgical Candidates. Obes Surg 2018; 29:252-261. [DOI: 10.1007/s11695-018-3515-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Bénard M, Bellisle F, Etilé F, Reach G, Kesse-Guyot E, Hercberg S, Péneau S. Impulsivity and consideration of future consequences as moderators of the association between emotional eating and body weight status. Int J Behav Nutr Phys Act 2018; 15:84. [PMID: 30189878 PMCID: PMC6127957 DOI: 10.1186/s12966-018-0721-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 08/30/2018] [Indexed: 01/09/2023] Open
Abstract
Background Emotional eating (EmE) is characterized by an over consumption of food in response to negative emotions and is associated with an increased weight status. Consideration of Future Consequences (CFC) or a low level of impulsivity could influence the association between EmE and weight status. The objective was to analyze the moderating influence of CFC and impulsivity on the relationship between EmE and BMI. Methods A total of 9974 men and 39,797 women from the NutriNet-Santé cohort study completed the revised 21-item Three-Factor Eating Questionnaire to assess their EmE, the CFC questionnaire (CFC-12) to assess their level of time perspective, and the Barratt Impulsiveness Scale (BIS-11) to assess their impulsivity. Weight and height were self-reported each year over a median follow-up of 5.3 years. The associations between EmE and repeated measures of BMI were estimated by multiple linear mixed-effects regression models stratified by gender, tertiles of the CFC, or tertiles of the BIS-11, taking into account sociodemographic and lifestyle factors. Results Overall, EmE was positively associated with BMI. CFC and impulsivity did not moderate the effect of EmE on changes of BMI per year, but quantitatively moderated the effect of EmE on overall BMI. In women, the strength of the association between EmE and weight status increased with CFC level. Difference of BMI slopes between a low and a high level of CFC was − 0.43 kg/m2 (95% CI: -0.55, − 0.30) (p < .0001). In addition, the strength of the association between emotional eating and weight status increased with impulsivity level. Difference of BMI slopes between a low and a high level of impulsivity was + 0.37 kg/m2 (95% CI: 0.24, 0.51) (p < .0001). In men, only individuals with a low CFC presented a stronger association of EmE with BMI. Conclusions Impulsivity and consideration of future consequences moderated the association between emotional eating and body weight status. This study emphasizes the importance of taking into account psychological traits in obesity prevention. Electronic supplementary material The online version of this article (10.1186/s12966-018-0721-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marc Bénard
- Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistique Sorbonne Paris Cité, INSERM U1153, INRA U1125, Cnam, Université Paris 13, Bobigny, France.
| | - France Bellisle
- Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistique Sorbonne Paris Cité, INSERM U1153, INRA U1125, Cnam, Université Paris 13, Bobigny, France
| | - Fabrice Etilé
- Paris School of Economics and INRA, UMR1393 PjSE, 48 Boulevard Jourdan, 75014, Paris, France
| | - Gérard Reach
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, Hôpital Avicenne, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistique Sorbonne Paris Cité, INSERM U1153, INRA U1125, Cnam, Université Paris 13, Bobigny, France
| | - Serge Hercberg
- Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistique Sorbonne Paris Cité, INSERM U1153, INRA U1125, Cnam, Université Paris 13, Bobigny, France.,Département de Santé Publique, Hôpital Avicenne, Bobigny, France
| | - Sandrine Péneau
- Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistique Sorbonne Paris Cité, INSERM U1153, INRA U1125, Cnam, Université Paris 13, Bobigny, France
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21
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Janse Van Vuuren MA, Strodl E, White KM, Lockie PD. Emotional food cravings predicts poor short‐term weight loss following laparoscopic sleeve gastrectomy. Br J Health Psychol 2018; 23:532-543. [DOI: 10.1111/bjhp.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/23/2017] [Indexed: 12/12/2022]
Affiliation(s)
| | - Esben Strodl
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
| | - Katherine M. White
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
| | - Philip D. Lockie
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
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22
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23
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Binge Eating, Loss of Control over Eating, Emotional Eating, and Night Eating After Bariatric Surgery: Results from the Toronto Bari-PSYCH Cohort Study. Obes Surg 2018; 28:2032-2039. [DOI: 10.1007/s11695-018-3137-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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24
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Bourdier L, Orri M, Carre A, Gearhardt AN, Romo L, Dantzer C, Berthoz S. Are emotionally driven and addictive-like eating behaviors the missing links between psychological distress and greater body weight? Appetite 2017; 120:536-546. [PMID: 29030085 DOI: 10.1016/j.appet.2017.10.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/20/2017] [Accepted: 10/09/2017] [Indexed: 01/24/2023]
Abstract
There is now a large body of evidence suggesting a significant association between emotional discomfort management, disordered eating behaviors and weight status. In the field of overweight and obesity, emotionally driven eating habits that resemble addictive behaviors are considered as a risk factor. This study aimed to investigate in a large sample of French university students 1) the associations between self-reported levels of psychological distress (PD), emotional eating (EE), food addiction (FA) and Body Mass Index (BMI); and 2) the potential mediation effect of eating behaviors (EE and FA) between PD and BMI. The responses of 1051 students (76.3% females) to self-reports assessing PD (Perceived Stress Scale, Hospital Anxiety and Depression Scale), EE (Intuitive Eating Scale-2) and FA (modified Yale Food Addiction Scale) were analysed. Associations between variables (Spearman correlation) and group comparisons by sex and BMI categories (Student's t tests/ANOVA) were tested, followed by Structural Equation Modeling (SEM) by sex. Among females and males, EE and FA scores were positively inter-related and correlated with PD scores and BMI. Moreover, among females and males, SEM showed that both EE and FA acts as mediators between PD and BMI. Hence, among educated young adults, using food consumption for down-regulating negative mood places the individual at risk for overweight and obesity. This study further emphasizes the necessity to take into account emotionally driven and addictive-like eating behaviors in interventions for promoting healthy eating and weight management.
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Affiliation(s)
- L Bourdier
- EA4430 CLIPSYD, University Paris Nanterre, 92000 Nanterre, France.
| | - M Orri
- CESP, INSERM, University Paris-Sud, UVSQ, University Paris-Saclay, 94800, Villejuif, France
| | - A Carre
- Univ. Savoie Mont Blanc, LIP/PC2S, F-73000, Chambéry, France
| | - A N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - L Romo
- EA4430 CLIPSYD, University Paris Nanterre, 92000 Nanterre, France; INSERM U894 CPN, CMME Centre Hospitalier Sainte Anne, 75014, Paris, France
| | - C Dantzer
- Laboratory of Psychology, University of Bordeaux, 33000 Bordeaux, France
| | - S Berthoz
- CESP, INSERM, University Paris-Sud, UVSQ, University Paris-Saclay, 94800, Villejuif, France; Psychiatry Unit, Institut Mutualiste Montsouris, 75014, Paris, France
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25
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Koball AM, Himes SM, Sim L, Clark MM, Collazo-Clavell ML, Mundi M, Kellogg T, Graszer K, Grothe KB. Distress Tolerance and Psychological Comorbidity in Patients Seeking Bariatric Surgery. Obes Surg 2017; 26:1559-64. [PMID: 26464243 DOI: 10.1007/s11695-015-1926-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION/PURPOSE Distress intolerance is characterized by a low threshold for negative emotional experiences and lack of emotion regulation and has been shown to predict various health outcomes. As such, the primary aim of this study was to determine the association between distress tolerance and psychological variables (eating behaviors, mood, substance use, trauma history), completion of bariatric surgery, and post-bariatric surgery weight loss outcomes and follow up with a provider. MATERIALS AND METHODS Two hundred forty-eight patients (75 % female, 89 % Caucasian) underwent a multidisciplinary evaluation for bariatric surgery and were assessed for psychiatric disorders via semi-structured clinical interview and psychometric questionnaires. RESULTS Low distress tolerance was associated with symptoms of depression (p ≤ 0.001), anxiety (p ≤ 0.001), disordered eating behaviors (p ≤ 0.001), substance abuse (p ≤ 0.001), a history of being the victim of childhood sexual abuse (p ≤ 0.001), and with high BMI (p < .05). Patients endorsing higher levels of distress tolerance were more likely to undergo bariatric surgery (p < .01). Distress tolerance was not related to 2-year post-surgical weight loss outcomes or follow up with a provider. CONCLUSION The ability to tolerate negative affect may be a variable that differentiates which patients undergo bariatric surgery rather than early postoperative outcomes.
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Affiliation(s)
- Afton M Koball
- Department of Behavioral Health, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA
| | - Susan M Himes
- Department of Psychiatry and Behavioral Medicine, Lahey Hospital and Medical Center, Burlington, MA, 01805, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Manpreet Mundi
- Department of Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Todd Kellogg
- Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Karen Graszer
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Karen B Grothe
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
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26
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Fox S, Conneely S, Egan J. Emotional expression and eating in overweight and obesity. Health Psychol Behav Med 2017. [DOI: 10.1080/21642850.2017.1378580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Susan Fox
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Sinéad Conneely
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jonathan Egan
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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27
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Reoperative Bariatric Surgery: a Systematic Review of the Reasons for Surgery, Medical and Weight Loss Outcomes, Relevant Behavioral Factors. Obes Surg 2017; 27:2707-2715. [DOI: 10.1007/s11695-017-2855-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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28
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Bongers P, Jansen A. Emotional Eating Is Not What You Think It Is and Emotional Eating Scales Do Not Measure What You Think They Measure. Front Psychol 2016; 7:1932. [PMID: 28008323 PMCID: PMC5143883 DOI: 10.3389/fpsyg.2016.01932] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/24/2016] [Indexed: 11/21/2022] Open
Abstract
In eating research, it is common practice to group people into different eater types, such as emotional, external and restrained eaters. This categorization is generally based on scores on self-report questionnaires. However, recent studies have started to raise questions about the validity of such questionnaires. In the realm of emotional eating, a considerable number of studies, both in the lab and in naturalistic settings, fail to demonstrate increased food intake in emotional situations in self-described emotional eaters. The current paper provides a review of experimental and naturalistic studies investigating the relationships between self-reported emotional eater status, mood, and food consumption. It is concluded that emotional eating scales lack predictive and discriminative validity; they cannot be assumed to measure accurately what they intend to measure, namely increased food intake in response to negative emotions. The review is followed by a discussion of alternative interpretations of emotional eating scores that have been suggested in the past few years, i.e., concerned eating, uncontrolled eating, a tendency to attribute overeating to negative affect, and cue-reactive eating.
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Affiliation(s)
- Peggy Bongers
- Eating Disorders and Obesity, Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University Maastricht, Netherlands
| | - Anita Jansen
- Eating Disorders and Obesity, Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University Maastricht, Netherlands
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29
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Novelle JM, Alvarenga MS. Cirurgia bariátrica e transtornos alimentares: uma revisão integrativa. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Realizar revisão sobre transtornos alimentares e comportamentos alimentares transtornados relacionados à cirurgia bariátrica. Métodos Revisão integrativa da literatura nas bases de dados PubMed, Lilacs, Bireme, portal SciELO com descritores indexados com critérios de inclusão: oferecer dado sobre a presença ou frequência de transtorno alimentar e/ou comportamentos alimentares disfuncionais previamente e/ou após a cirurgia. Resultados Foram selecionados 150 estudos (14 nacionais e 136 internacionais): 80,6% eram com avaliação de pacientes pré-/pós-cirúrgicos; 12% eram estudos de caso e 7,3% eram estudos de revisão. Diferentes instrumentos foram usados para avaliação, principalmente o Questionnaire on Eating and Weight Patterns, a Binge Eating Scale e Eating Disorders Examination Questionnaire. A compulsão alimentar foi o comportamento mais avaliado, com frequências/prevalências variando de 2% a 94%; no caso do transtorno da compulsão alimentar as frequências/prevalências variaram de 3% a 61%. Houve também a descrição de anorexia e bulimia nervosa, síndrome da alimentação noturna e comportamento beliscador. Alguns estudos apontam melhora dos sintomas no pós-cirúrgico e/ou seguimento enquanto outros apontam surgimento ou piora dos problemas. Conclusão Apesar da variabilidade entre métodos e achados, comportamentos alimentares disfuncionais são muito frequentes em candidatos à cirurgia bariátrica e podem ainda surgir ou piorar após a intervenção cirúrgica. Profissionais de saúde devem considerar de maneira mais cuidadosa tais problemas neste público, dadas às consequências para o resultado cirúrgico e qualidade de vida.
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30
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Opozda M, Chur-Hansen A, Wittert G. Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre-post studies. Obes Rev 2016; 17:770-92. [PMID: 27296934 DOI: 10.1111/obr.12425] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/31/2022]
Abstract
Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours.
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Affiliation(s)
- M Opozda
- School of Psychology, University of Adelaide, Adelaide, Australia.,Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, Australia, and Centre for Nutrition and Gastro-Intestinal Diseases, South Australian Health and Medicine Research Institute, Adelaide, Australia
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31
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Wood KV, Ogden J. Patients' long-term experiences following obesity surgery with a focus on eating behaviour: A qualitative study. J Health Psychol 2016; 21:2447-2456. [PMID: 25869729 DOI: 10.1177/1359105315578304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored long-term consequences of obesity surgery. Interpretative phenomenological analysis was used to analyse transcripts of 10 interviews with patients who underwent surgery 8 or more years ago. Experiences were described under three broad themes: eating behaviours, relationship with food and quality of life. Although patients described variability within these themes, describing different patterns of change, analysis revealed associations between themes and outcomes. In particular, those who reported successful weight loss also described the functionalization of food, the development of new coping strategies and a process of positive reinvention creating a new sense of self.
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Psychosocial presentation of female bariatric surgery patients after multiple revisional surgeries: A qualitative study. J Health Psychol 2016; 23:1261-1272. [DOI: 10.1177/1359105316648673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Bariatric surgery is currently the most viable and cost-effective treatment for obesity. This study aimed to understand, from a female patient’s perspective, what contributed to not achieving or maintaining excess weight loss from a primary laparoscopic adjustable gastric band surgery, leading to subsequent multiple revisional bariatric surgeries. The purposive sample of participants ( N = 17 females) were over 18 years, had a primary failed laparoscopic adjustable gastric band and had more than three revisional procedures. Participants were individually interviewed and data were analysed from a grounded theory methodology to build a causal model with the core category of unrealistic expectations of bariatric surgery and other important conceptual categories.
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Salwen JK, Hymowitz GF. The Weight-Related Abuse Questionnaire (WRAQ): Reliability, validity, and clinical utility. Eat Behav 2015; 19:150-4. [PMID: 26402044 DOI: 10.1016/j.eatbeh.2015.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/05/2015] [Accepted: 09/16/2015] [Indexed: 11/26/2022]
Abstract
Weight-related teasing (WRT)/stigmatization may be distinct from teasing and general abuse and may differentially impact adult outcomes. As WRT increases in severity so do depression and disordered eating. Currently, there are no validated measures designed to assess abuse specific to weight. Thus, we developed the Weight-Related Abuse Questionnaire (WRAQ) and validated it in young adult and clinically obese populations. The WRAQ was administered to 3 samples of participants: 292 undergraduate students, 382 undergraduate students, and 59 individuals seeking bariatric surgery. Concurrent validity was assessed via measures of WRT and general childhood abuse. Convergent validity was assessed with measures of depression and disordered eating. Study 1 data were used to further develop the structure of the WRAQ. Study 2 indicated that the WRAQ had excellent psychometric properties (based on factor analyses and reliability/scale consistency analysis) and strong concurrent and convergent validity, supporting the validity of the questionnaire. 6-month test-retest reliability was also good. In Study 3 responses on the WRAQ converged well with interview responses, showed good psychometric properties, and showed moderate correlations with measures of childhood abuse and psychopathology. The WRAQ has strong psychometric properties and is strongly associated with measures of current psychopathology. Additionally, it fills a gap in the assessment literature and may be a beneficial tool for determining which individuals are at increased risk for psychopathology.
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Affiliation(s)
- Jessica K Salwen
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, United States.
| | - Genna F Hymowitz
- Departments of Psychology, Psychiatry, & Surgery, Stony Brook University, Stony Brook, NY 11794-2500, United States.
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Janse Van Vuuren M, Strodl E, White KM, Lockie P. Psychosocial presentation of revisional LAGB patients: a qualitative study. Clin Obes 2015; 5:273-80. [PMID: 26278522 DOI: 10.1111/cob.12113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/18/2015] [Accepted: 07/17/2015] [Indexed: 12/21/2022]
Abstract
This qualitative study offers insight into the experiences, expectations, perceptions and beliefs that may lead to laparoscopic adjustable gastric band patients' failure to achieve expected weight loss and seek revisional bariatric surgery. The 23 participants from two sites were interviewed and data were analysed from a grounded theory methodology in order to build a causal model. Analysis of participants' reports identified 'unrealistic expectations of the LAGB' as the core category. Additionally, the restriction of the band had a negative impact on participants' social interactions, leading to feelings of deprivation and, thus, to a desire for reward from food choices and consequently an increase of consumption of high-calorie-dense foods. These foods were chosen because of their specific texture or ability to provide reward. The resulting increase in weight or failure to achieve excess weight loss, led to feelings of shame and loneliness and emotional eating resulting in increased the consumption of rewarding foods. Thus, identifying unrealistic expectations of laparoscopic adjustable gastric band (LAGB) and emotional eating behaviours are important in those who are present initially for primary bariatric and revisional bariatric surgery, as they may contribute specifically to these patients' weight regain and consequent failure to achieve excess weight loss.
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Affiliation(s)
- M Janse Van Vuuren
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - E Strodl
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - K M White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - P Lockie
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Goldbacher E, La Grotte C, Komaroff E, Vander Veur S, Foster GD. An initial evaluation of a weight loss intervention for individuals who engage in emotional eating. J Behav Med 2015; 39:139-50. [DOI: 10.1007/s10865-015-9678-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/26/2015] [Indexed: 11/30/2022]
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Conceição EM, Utzinger LM, Pisetsky EM. Eating Disorders and Problematic Eating Behaviours Before and After Bariatric Surgery: Characterization, Assessment and Association with Treatment Outcomes. EUROPEAN EATING DISORDERS REVIEW 2015; 23:417-25. [PMID: 26315343 PMCID: PMC4861632 DOI: 10.1002/erv.2397] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/30/2015] [Indexed: 01/22/2023]
Abstract
Accumulating evidence suggests that bariatric surgery candidates are likely to present with eating disorders (EDs) and/or problematic eating behaviours (EBs), and research suggests that these problems may persist or develop after bariatric surgery. While there is growing evidence indicating that EDs and EBs may impact bariatric surgery outcomes, the definitions and assessment methods used lack consensus, and findings have been mixed. The aims of this paper were (1) to summarize the existing literature on pre‐operative and post‐operative EDs and problematic EBs; (2) to discuss the terms, definitions and assessment measures used across studies; and (3) to consider the extent to which the presence of these problems impact surgery outcomes. We highlight the importance of investigators utilizing consistent definitions and assessment methodologies across studies. © 2015 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.
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Affiliation(s)
| | - Linsey M Utzinger
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Opolski M, Chur-Hansen A, Wittert G. The eating-related behaviours, disorders and expectations of candidates for bariatric surgery. Clin Obes 2015; 5:165-97. [PMID: 26173752 DOI: 10.1111/cob.12104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 05/13/2015] [Accepted: 05/21/2015] [Indexed: 12/17/2022]
Abstract
It is important that clinicians and researchers understand the possible eating-related difficulties experienced by pre-bariatric surgery candidates, as well as their expectations of how their eating and hunger will change after surgery. This review examines English-language publications related to the eating-related behaviours, disorders and expectations of bariatric candidates. Seventy-five articles related to binge eating disorder, grazing, night eating syndrome, emotional eating, food cravings and addiction, and pre-surgical expectations of post-surgical eating in this population were critically reviewed. A variety of often problematic eating behaviours appear more common in bariatric candidates than in non-obese populations. The literature suggests that 4-45% of candidates may have binge eating disorder, 20-60% may graze, 2-42% may have night eating syndrome, 38-59% may engage in emotional eating and 17-54% may fit criteria for food addiction. Binge eating may also be more prevalent in bariatric candidates than in similarly obese non-surgical individuals. Expectations of surgery are high, with pre-surgical candidates believing their bariatric procedure will virtually guarantee significantly improved eating behaviours. Study replications are needed, and further investigation into prevalence, impacts and candidate characteristics related to disordered eating behaviours, as well as candidates' expectations of eating after surgery, will be important. Further comparisons of bariatric candidates to similarly obese non-bariatric populations will be important to understand eating-related characteristics of candidates beyond those related to their weight. Future research may be improved by the use of validated measures, replicable methodologies, minimization of data collected in circumstances where respondents may been motivated to 'fake good', use of prospective data and consistent definitions of key terminology.
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Affiliation(s)
- M Opolski
- School of Psychology, University of Adelaide, Adelaide, Australia
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
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Self-Reported Eating Disorder Symptoms Before and After Gastric Bypass and Duodenal Switch for Super Obesity—a 5-Year Follow-Up Study. Obes Surg 2015; 26:588-94. [DOI: 10.1007/s11695-015-1790-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Dietary and psych predictors of weight loss after gastric bypass. J Surg Res 2015; 197:283-90. [PMID: 25940162 DOI: 10.1016/j.jss.2015.04.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/08/2015] [Accepted: 04/03/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Identifying severely obese patients who will succeed after bariatric surgery remains challenging. Although numerous studies have attempted to identify preoperative patient characteristics associated with weight loss, the roles of many dietary and psychological characteristics are unclear. The purpose of this study was to examine preoperative dietary and psychological predictors of successful weight loss after bariatric surgery. MATERIALS AND METHODS This retrospective cohort study included all patients who underwent laparoscopic Roux-en-Y gastric bypass from September 2011-June 2013 at a single institution (n = 124). Patient demographics, comorbidities, dietary and psychological factors, and weight loss outcomes were extracted from the electronic medical record. Bivariate associations between these factors and successful weight loss (≥50% excess body weight) were examined. Factors significant at P ≤ 0.1 were included in a multivariate logistic regression model. RESULTS On bivariate analysis, absence of either type 2 diabetes or hypertension, preoperative weight <270 lbs, no intentional past weight loss >50 lbs, no previous purging or family history of obesity, and no soda consumption preoperatively were associated with successful weight loss (P < 0.1). On multivariate analysis, successful weight loss was inversely associated with the presence of type 2 diabetes (odds ratio [OR], 0.22, 95% confidence interval [CI], 0.06-0.73), maximum intentional past weight loss >50 lbs (OR, 0.12 [95% CI, 0.04-0.43]), and decreasing soda consumption by >50% (OR, 0.27 [95% CI, 0.08-0.99]). CONCLUSIONS Patients with type 2 diabetes mellitus, significant previous weight loss, and poor soda consumption habits are more likely to experience suboptimal weight loss after bariatric surgery. Additional preoperative counseling and close postoperative follow-up is warranted for these patients.
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40
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Mason TB. Parental instrumental feeding, negative affect, and binge eating among overweight individuals. Eat Behav 2015; 17:107-10. [PMID: 25682364 DOI: 10.1016/j.eatbeh.2015.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 01/29/2015] [Indexed: 11/27/2022]
Abstract
Parental instrumental feeding (i.e., rewarding children with food for perceived correct behaviors and punishing by taking away food for perceived incorrect behaviors) and negative affect are independently associated with binge eating in adulthood. However, less is known about interactions between these variables and binge eating. This study examined the relationship of retrospective reports of parental feeding practices and negative affect to binge eating. Participants were 165 overweight and obese undergraduate students at a large Mid-Atlantic University. High parental instrumental feeding strengthened the relationship between negative affect and binge eating. Also, individuals who reported low parental feeding practices reported similar binge eating regardless of negative affect. These findings suggest that overweight and obese individuals whose parents used more instrumental feeding practices are most likely to engage in binge eating in response to negative affect.
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Affiliation(s)
- Tyler B Mason
- Department of Psychology, Old Dominion University, Norfolk, VA 23529, United States.
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Konttinen H, Peltonen M, Sjöström L, Carlsson L, Karlsson J. Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study. Am J Clin Nutr 2015; 101:16-24. [PMID: 25527746 DOI: 10.3945/ajcn.114.095182] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery. OBJECTIVE We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity. DESIGN Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy. RESULTS The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P < 0.001 in both sexes) than the control group did. Pretreatment eating behaviors were unrelated to subsequent weight changes in surgically treated patients. However, patients who had lower levels of 6-mo and 1-y disinhibition and hunger (β = 0.13-0.29, P < 0.01 in men; β = 0.11-0.28, P < 0.001 in women) and experienced larger 1-y decreases in these behaviors (β = 0.31-0.48, P < 0.001 in men; β = 0.24-0.51, P < 0.001 in women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes. CONCLUSION A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions.
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Affiliation(s)
- Hanna Konttinen
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Markku Peltonen
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Lars Sjöström
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Lena Carlsson
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Jan Karlsson
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
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Baldofski S, Tigges W, Herbig B, Jurowich C, Kaiser S, Stroh C, de Zwaan M, Dietrich A, Rudolph A, Hilbert A. Nonnormative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome. Surg Obes Relat Dis 2014; 11:621-6. [PMID: 25887494 DOI: 10.1016/j.soard.2014.09.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 08/29/2014] [Accepted: 09/03/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study sought to investigate the prevalence of BED and NES and associations with various forms of nonnormative eating behavior and psychopathology in prebariatric patients. Within a consecutive multicenter registry study, patients in 6 bariatric surgery centers in Germany were recruited. METHODS Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures. RESULTS Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Co-morbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge-eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED. CONCLUSION BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity.
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Affiliation(s)
- Sabrina Baldofski
- Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany.
| | - Wolfgang Tigges
- Department of General Surgery, Asklepios Clinic, Hamburg, Germany
| | - Beate Herbig
- Schön Klinik Hamburg Eilbek Bariatric Clinic, Hamburg, Germany
| | - Christian Jurowich
- Department of General, Visceral, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric, and Vascular Surgery, Hospital Konstanz, Konstanz, Germany
| | - Christine Stroh
- Department of General, Abdominal and Pediatric Surgery, SRH Municipal Hospital, Gera, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Arne Dietrich
- Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Almut Rudolph
- Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany
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Parker K, Brennan L. Measurement of disordered eating in bariatric surgery candidates: a systematic review of the literature. Obes Res Clin Pract 2014; 9:12-25. [PMID: 25660171 DOI: 10.1016/j.orcp.2014.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/09/2014] [Accepted: 01/25/2014] [Indexed: 12/16/2022]
Abstract
Symptoms of disordered eating are common among patients seeking bariatric surgery, and assessment of eating pathology is typical in pre-surgical evaluations. A systematic review was conducted to evaluate the definitions, diagnostic criteria and measures used to assess disordered eating in adults seeking bariatric surgery. The review identified 147 articles featuring 34 questionnaires and 45 interviews used in pre-surgical assessments. The Questionnaire on Eating and Weight Patterns Revised and the Structured Clinical Interview for DSM were the most frequently used questionnaire and interview respectively. Variations to pre-surgical diagnostic criteria included changes to the frequency and duration criteria for binge eating, and inconsistent use of disordered eating definitions (e.g., grazing). Results demonstrate a paucity of measures designed specifically for an obese sample, and only 24% of questionnaires and 4% of interviews used had any reported psychometric evaluation in bariatric surgery candidates. The psychometric data available suggest that interview assessments are critical for accurately identifying binge episodes and other diagnostic information, while self-report questionnaires may be valuable for providing additional information of clinical utility (e.g., severity of eating, shape and weight-related concerns). Findings highlight the need for consensus on disordered eating diagnostic criteria and psychometric evaluation of measures to determine whether existing measures provide a valid assessment of disordered eating in this population. Consistent diagnosis and the use of validated measures will facilitate accurate identification of disordered eating in the pre-surgical population to enable assessment of suitability for surgery and appropriate targeting of treatment for disordered eating to optimise treatment success.
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Affiliation(s)
- Katrina Parker
- Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Victoria, Australia; School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia
| | - Leah Brennan
- Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Victoria, Australia; School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia.
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Miller-Matero LR, Armstrong R, McCulloch K, Hyde-Nolan M, Eshelman A, Genaw J. To eat or not to eat; is that really the question? An evaluation of problematic eating behaviors and mental health among bariatric surgery candidates. Eat Weight Disord 2014; 19:377-82. [PMID: 24878835 DOI: 10.1007/s40519-014-0118-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 03/20/2014] [Indexed: 11/24/2022] Open
Abstract
Problematic eating behaviors, such as emotional eating, and food addiction, may affect weight; however, little is known about these eating behaviors, especially among those seeking bariatric surgery. Therefore, the purpose of this study was to estimate the prevalence of problematic eating behaviors and to investigate their relationship with other eating behaviors, body mass index (BMI), and psychiatric symptoms. There were 142 patients who completed a required psychiatric evaluation prior to bariatric surgery. Of these, 16.9 % met criteria for a food addiction and 25.4-40.7 % endorsed emotional eating, depending on type of emotional eating. The number of food addiction symptoms endorsed was related to emotional eating. Both food addiction and emotional eating were related to anxiety and depressive symptoms. However, surprisingly, BMI was not related to a food addiction diagnosis, emotional eating scores, or psychiatric symptoms. Results from this study suggest that problematic eating behaviors are occurring among bariatric surgery candidates. Furthermore, this study may help to address the conflicting research regarding the effects of psychiatric symptoms on weight-loss outcomes. Perhaps it is the problematic eating behaviors (e.g., food addiction and emotional eating) that are associated with psychiatric symptoms that could be influencing outcomes. Future research should evaluate treatments for problematic eating behaviors and whether treatments improve weight-loss success.
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Affiliation(s)
- Lisa Renee Miller-Matero
- Behavioral Health, Henry Ford Health System, Henry Ford Hospital, 2799 W. Grand Blvd. CFP-2, Detroit, MI, 48202, USA,
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Gade H, Rosenvinge JH, Hjelmesæth J, Friborg O. Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery. Obes Facts 2014; 7:111-9. [PMID: 24685661 PMCID: PMC5644889 DOI: 10.1159/000362257] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/08/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. DESIGN The study used cross-sectional data collected by running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). SUBJECTS A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI of 43.5 (4.4) kg/m(2) participated. MEASUREMENTS Measurements included the NEO-PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ-R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR)) and the HADS (anxiety and depression). RESULTS The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating than anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than in male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. CONCLUSION Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour.
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Affiliation(s)
- Hege Gade
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Tromsø, Tromsø, Norway
- *Hege Gade, Morbid Obesity Centre, Vestfold Hospital Trust, P.B. 2168, 3103 Tønsberg (Norway),
| | | | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oddgeir Friborg
- Department of Psychology, University of Tromsø, Tromsø, Norway
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Bast ES, Berry EM. Laugh Away the Fat? Therapeutic Humor in the Control of Stress-induced Emotional Eating. Rambam Maimonides Med J 2014; 5:e0007. [PMID: 24498514 PMCID: PMC3904482 DOI: 10.5041/rmmj.10141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This review explores the potential overlap between the fields of nutrition and therapeutic humor, together with the role of humor as a possible tool for aiding those in whom emotions, particularly negative ones, trigger eating as a means to improve mood. We review emotional eating, obesity, and the hypothesized mechanisms of emotional eating. We then review the field of therapeutic humor and its ability to de-stress individuals, possibly through endorphin and opioid systems, both of which are also involved in eating behavior. Finally, we present a novel hypothesis that people may be trained to use humor as a "food substitute" at best, or to blunt hunger stimuli, to achieve similar advantages, without the side effect of weight gain.
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Affiliation(s)
- Elizabeth S. Bast
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States and
| | - Elliot M. Berry
- Department of Human Nutrition & Metabolism, Braun School of Public Health, Faculty of Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Coulman KD, Abdelrahman T, Owen-Smith A, Andrews RC, Welbourn R, Blazeby JM. Patient-reported outcomes in bariatric surgery: a systematic review of standards of reporting. Obes Rev 2013; 14:707-20. [PMID: 23639053 DOI: 10.1111/obr.12041] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/20/2013] [Accepted: 04/01/2013] [Indexed: 12/01/2022]
Abstract
Bariatric surgery is increasingly being used to treat severe obesity, but little is known about its impact on patient-reported outcomes (PROs). For PRO data to influence practice, well-designed and reported studies are required. A systematic review identified prospective bariatric surgery studies that used validated PRO measures. Risk of bias in randomized controlled trials (RCTs) was assessed, and papers were examined for reporting of (i) who completed PRO measures; (ii) missing PRO data and (iii) clinical interpretation of PRO data. Studies meeting all criteria were classified as robust. Eighty-six studies were identified. Of the eight RCTs, risk of bias was high in one and unclear in seven. Sixty-eight different PRO measures were identified, with the Short Form (SF)-36 questionnaire most commonly used. Forty-one (48%) studies explicitly stated measures were completed by patients, 63 (73%) documented missing PRO data and 50 (58%) interpreted PRO data clinically. Twenty-six (30%) met all criteria. Although many bariatric surgery studies assess PROs, study design and reporting is often poor, limiting data interpretation and synthesis. Well-designed studies that include agreed PRO measures are needed with reporting to include integration with clinical outcomes to inform practice.
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Affiliation(s)
- K D Coulman
- Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Bristol, UK; Department of Bariatric and Upper GI Surgery, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
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Effect of Consecutive Intragastric Balloon (BIB®) Plus Diet Versus Single BIB® Plus Diet on Eating Disorders Not Otherwise Specified (EDNOS) in Obese Patients. Obes Surg 2013; 23:2075-9. [DOI: 10.1007/s11695-013-1028-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Silva SSPD, Maia ÂDC. Patients’ perceptions, health and psychological changes with obesity treatment: Success and failure in a triangulation study. Health (London) 2013. [DOI: 10.4236/health.2013.511236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Goldbacher EM, Grunwald HE, Lagrotte CA, Klotz AA, Oliver TL, Musliner KL, Vanderveur SS, Foster GD. Factor structure of the Emotional Eating Scale in overweight and obese adults seeking treatment. Appetite 2012; 59:610-5. [PMID: 22510311 PMCID: PMC3428423 DOI: 10.1016/j.appet.2012.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 03/28/2012] [Accepted: 04/05/2012] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine the factor structure and anthropometric correlates of the Emotional Eating Scale in overweight and obese adults presenting for weight loss. Participants were 217 men and women with a mean body-mass index of 33.1 (±3.4) kg/m². Results indicated a four factor structure: depression, anger, anxiety, and somatic arousal. These factors demonstrated strong internal consistency, and together accounted for approximately 60% of the total variance. Women had significantly higher depression and total scores than did men. There were no significant correlations between the Emotional Eating Scale scores and anthropometric measures. This work begins to add to the literature base regarding the applicability of the original design of the Emotional Eating Scale for samples consisting of men and African Americans.
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Affiliation(s)
- E M Goldbacher
- Department of Psychology, La Salle University, 1900 W. Olney Ave., Philadelphia, PA 19141, USA.
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