Obesity Surgery

, Volume 28, Issue 6, pp 1553–1561 | Cite as

Emotion Self-Regulation Moderates the Association Between Symptoms of ADHD and Weight Loss After Bariatric Surgery

  • Tamara M. Williamson
  • Tavis S. Campbell
  • Jo Ann Telfer
  • Joshua A. Rash
Original Contributions



This study aimed to examine the combined effect of pre-surgical emotion self-regulation (ESR) and symptoms of attention deficit hyperactivity disorder (sADHD, i.e., inattention, impulsivity, and hyperactivity) on weight loss 12 months following bariatric surgery independent of psychological distress and eating pathology.


Adults with obesity were recruited from a bariatric surgery specialty clinic in Canada. Patients completed measures of psychological distress (i.e., Beck Depression Inventory II and Beck Anxiety Inventory), eating pathology (i.e., Eating Disorder Examination Questionnaire), ESR (i.e., “Managing Own Emotions” subscale of the Schutte Emotional Intelligence Test), and sADHD (i.e., Adult ADHD Self-Report Scale) prior to surgery. Measures of height and weight were obtained and used to calculate percent excess weight loss (%EWL) of body mass index (BMI) pre- and 12 months post-surgery.


Thirty-seven patients were recruited. The final sample consisted of 30 patients (80% female; mean age = 48 years; mean BMI = 49.32). Patients experienced significant weight loss and reported significant improvement in anxiety, depressed mood, and eating pathology from pre- to 12 months post-surgery. A significant sADHD by ESR interaction on %EWL (F(1, 21) = 6.43, p = .019) was observed and accounted for 13% of unique variance after adjusting for relevant covariates. Probing the interaction with the Johnson-Neyman technique indicated that there was a significant inverse association between sADHD and %EWL among individuals who scored ≤ 0.15 SD below the mean on ESR.


ESR moderated the association between sADHD and %EWL, suggesting that sADHD may attenuate weight loss following bariatric surgery among individuals deficient in ESR. This finding has implications for bariatric surgery pre-surgical psychological assessment.


Bariatric surgery Deficient emotion self-regulation Obesity Adult ADHD Psychological distress Eating pathology 



Ms. Williamson wishes to acknowledge the support of the Program for Undergraduate Research Experience (PURE) and the Markin Undergraduate Student Research Program in Health and Wellness (USRP) at the University of Calgary for their generous support of this project. Moreover, the authors wish to acknowledge the staff and management at the Calgary Adult Bariatric Specialty Clinic for their support and cooperation with this research.


No third-party funding was received in connection with this research.

Compliance with Ethical Standards

Conflict of Interest

The authors have no conflicts of interest to report, financial or otherwise.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Tamara M. Williamson
    • 1
  • Tavis S. Campbell
    • 1
  • Jo Ann Telfer
    • 2
  • Joshua A. Rash
    • 3
  1. 1.Department of PsychologyUniversity of CalgaryCalgaryCanada
  2. 2.Calgary Adult Bariatric Specialty ClinicRichmond Road Diagnostic and Treatment CentreCalgaryCanada
  3. 3.Department of PsychologyMemorial University of NewfoundlandSt. John’sCanada

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