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Disinhibition and Subjective Hunger as Mediators Between Weight Bias Internalization and Binge Eating Among Pre-Surgical Bariatric Patients

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Abstract

Purpose

Weight bias internalization, or the process of applying negative weight-related attitudes and beliefs to oneself, is an important construct in regard to patients pursuing bariatric surgery. Weight bias internalization (or internalized weight bias) has been previously associated with depressive symptoms and binge eating among pre-surgical bariatric patients. However, a gap in the literature exists pertaining to how certain eating behaviors may mediate the relationship between weight bias internalization and binge eating. The present study assessed the role of eating behaviors (i.e., cognitive restraint, disinhibition, and hunger) as mediators between weight bias internalization and binge eating symptoms when controlling for depression.

Materials and Methods

A total of 708 adults (Mage = 42.91; White = 95.3%; women = 79.4%) seeking bariatric surgery at a tertiary academic medical center in the Appalachia region of the USA were included in this retrospective study. Patients completed validated measures of weight bias internalization, eating behaviors, and depression as part of a routine, psychological evaluation in order to determine surgical clearance.

Results

Disinhibition and hunger were significant mediators in the relationship between weight bias internalization and binge eating beyond the role of depressive symptoms alone.

Conclusion

Disinhibited eating, or the tendency to experience a loss of control and eating in response to negative emotions, as well as subjective feelings of hunger are important dimensions of eating, particularly as related to weight bias internalization and binge eating. Weight bias internalization is an important factor to consider among pre-surgical bariatric patients and warrants additional treatment considerations.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA

    Zachary A. Soulliard

  2. Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV, 26505, USA

    Cassie Brode & Stephanie Cox

  3. Department of Surgery, One Medical Center Drive, West Virginia University School of Medicine, P.O. Box 9238, Morgantown, WV, 26506, USA

    Lawrence E. Tabone, Nova Szoka & Salim Abunnaja

Authors
  1. Zachary A. Soulliard
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  2. Cassie Brode
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  4. Nova Szoka
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  6. Stephanie Cox
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Correspondence to Zachary A. Soulliard.

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Conflict of Interest

Dr. Cassie Brode was supported by the National Institute of General Medical Sciences, 5U54GM104942-03. Dr. Nova Szoka reports serving as a consultant for Johnson & Johnson and CMR Surgical. No other disclosures among the authors exist.

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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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Soulliard, Z.A., Brode, C., Tabone, L.E. et al. Disinhibition and Subjective Hunger as Mediators Between Weight Bias Internalization and Binge Eating Among Pre-Surgical Bariatric Patients. OBES SURG 31, 797–804 (2021). https://doi.org/10.1007/s11695-020-05023-z

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