Emotional Impact on Health Behavior Adherence After Bariatric Surgery: What About Positive Psychological Constructs?
- 90 Downloads
Health behaviors are critical for weight loss maintenance after weight loss surgery (WLS), and emotional factors often play a role in adherence. Positive psychological constructs (e.g., optimism, positive affect) have predicted health outcomes in other medical populations but have been infrequently examined in post-WLS patients.
This study measured optimism and positive affect in post-WLS patients recruited from online support groups. A hierarchical linear regression analysis tested their association with health behavior adherence, physical activity, and weight loss, controlling for demographic and weight-related covariates. It also tested depression and anxiety symptoms as moderators.
In 95 participants, positive affect was associated with better adherence (b = 0.41, p < 0.01) and greater moderate-to-vigorous physical activity (b = 0.20, p < 0.001) controlling for demographic/weight-related covariates, and independently with more weight loss (b = 0.24, p < 0.05). Optimism was independently associated with better adherence (b = 0.32, p < 0.05) and with greater moderate-to-vigorous physical activity controlling for demographic/weight-related covariates (b = 0.16, p < 0.05). These associations no longer reached statistical significance controlling for depression and anxiety symptoms. Anxiety symptoms moderated the relationship between positive affect and adherence (b = 0.06, p < 0.01), and depression (b = 0.15, p < 0.01) and anxiety (b = 0.02, p < 0.05) symptoms each moderated the relationship between optimism and walking, such that there was a stronger relationship between positive psychological constructs and health behaviors for those with higher anxiety or depression scores.
Positive psychological states should be included when assessing emotional factors related to health behaviors in post-WLS patients. Interventions targeting health behaviors may be improved with inclusion of skills to boost positive psychological states.
KeywordsPositive psychology Health behaviors Physical activity Optimism Emotion Health psychology Adherence
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflicts of interest.
- 2.Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.Google Scholar
- 9.Wakayama L, Nameth K, Adler S, Safer DL. Replication and extension of dietary adherence as a predictor of suboptimal weight loss outcomes in post-bariatric patients. Surg Obes Relat Dis Elsevier Inc; 2019. https://doi.org/10.1016/j.soard.2018.10.029.
- 16.Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient-2013 update. Obesity. 2013;9:159–91.Google Scholar
- 29.Browning C, Sims J, Kendig H, et al. Predictors of physical activity behavior in older community-dwelling adults. J Allied Health. 2009;38:8–17.Google Scholar
- 33.Ghorpade K, Abhyankar S. Some positive personality correlates of adherence to treatment among post bariatric surgery patients. Indian J Posit Psychol. 2014;4:51–4.Google Scholar
- 47.Celano CM, Albanese AM, Millstein RA, et al. Optimizing a positive psychology intervention to promote health behaviors following an acute coronary syndrome: the positive emotions after acute coronary events-III (PEACE-III) randomized factorial trial. Psychosom Med. 2018;80:526–34.Google Scholar
- 48.Celano CM, Gianangelo TA, Millstein RA, et al. A positive psychology–motivational interviewing intervention for patients with type 2 diabetes: proof-of-concept trial. Int J Psychiatry Med. 2018:009121741879144.Google Scholar