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Body Image and Emotional Eating as Predictors of Psychological Distress Following Bariatric Surgery

Abstract

Background

The purpose of this study was to shed light on the ambiguity concerning the variables affecting psychological distress following bariatric surgery, specifically the roles of body image dissatisfaction (BID) and emotional eating in detecting and predicting such outcomes.

Methods

Of 169 consecutive bariatric surgery candidates from a university-based bariatric center, who participated in the psychosocial pre-surgery survey from 2015 to 2017 (67% females, mean age 41.8 years (SD = 11.46), mean body mass index (BMI) 42.0 kg/m2 (SD = 11.0)), 81 patients consented to be included in the follow-up phase (56% females, mean age 44.3 years (SD = 12.3, range 21–70), and BMI 30.1 kg/m2 (SD = 6.2, range 19.7 to 56.2)). Risk of suicide (SBQ-R), depressive symptoms (PHQ-9), anxiety symptoms (PHQ-7), emotional eating behaviors (EES), and body image dissatisfaction (BID-BSQ8) measures were assessed before and after surgery.

Results

Post-surgery improvements were observed in body image and emotional eating total measures, as well as in percent total weight loss (TWL%) and percent excess weight loss (EWL%), but not in psychological distress outcomes. However, improvement in BID predicted better post-surgery in all the psychological distress outcomes whereas improvement in emotional eating predicted less post-surgery depression. Post-surgery BID positively correlated with depression and anxiety, whereas post-surgery emotional eating positively correlated with anxiety.

Conclusions

Weight loss is insufficient to determine a change in psychological distress following surgery. Physicians and other health professionals who treat bariatric surgery patients should be encouraged to asses BID pre- and post-surgery, as it is a sensitive indicator of improvement of psychological well-being after surgery.

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Author information

All authors declare that they have substantially contributed to the manuscript and have met the main criteria of authorship: conceptualization, methodology, data collecting and processing, writing and editing, and supervision.

Correspondence to Shulamit Geller.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cite this article

Geller, S., Dahan, S., Levy, S. et al. Body Image and Emotional Eating as Predictors of Psychological Distress Following Bariatric Surgery. OBES SURG (2019) doi:10.1007/s11695-019-04309-1

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Keywords

  • Psychological distress
  • Body image dissatisfaction
  • Emotional eating
  • Bariatric surgery
  • Follow-up
  • Weight loss