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Associations among psychopathology and eating disorder symptoms and behaviors in post-bariatric surgery patients

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Abstract

Purpose

A considerable number of post-bariatric surgery patients report problematic eating behaviors (PEBs) and/or eating disorders (EDs). Examining psychosocial variables associated with ED symptoms may identify targets for postoperative interventions to reduce these behaviors and improve surgical outcomes.

Methods

A total of 161 participants completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Eating Disorder Examination-Questionnaire (EDE-Q). Participants were classified into ED risk or no ED risk groups and subjective binge eating (SBE) or no SBE groups. Independent-sample t tests were computed to examine mean differences in total weight loss (%TWL) and MMPI-2-RF scale scores between the ED groups. Relative Risk Ratios (RRRs) were computed to determine which MMPI-2-RF scales were associated with increased risk of ED group membership.

Results

The ED risk group lost significantly less weight (19.36% TWL) than the no ED risk group (25.18% TWL). The SBE group lost significantly less weight (17.98% TWL) than the no SBE group (25.57% TWL). Participants in the ED groups scored significantly higher on internalizing and externalizing MMPI-2-RF scales than the no ED groups. These scales were associated with increased risk (1.55–2.55 times the risk) of being classified into the ED groups.

Conclusions

Patients who experienced postoperative ED symptoms lost significantly less weight than patients without ED symptoms. Postoperative ED symptoms are related to, and may be impacted by, higher levels of internalizing and externalizing dysfunction after surgery. Postoperative assessment of and interventions targeting psychosocial dysfunction could decrease ED symptoms.

Level of evidence

III: Evidence obtained from well-designed cohort or case–control analytic studies.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

Ryan Marek received research funding from the University of Minnesota Press, Society for Personality Assessment, and APA Division 12, Section IX to collect data used in this study. Yossef Ben-Porath received research funding from the University of Minnesota Press to collect data used in this study.

Author information

Authors and Affiliations

  1. Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA

    Katy W. Martin-Fernandez & Yossef S. Ben-Porath

  2. Department of Psychology, University of Akron, Akron, OH, 44325, USA

    Javier Martin-Fernandez

  3. Department of Primary Care, Sam Houston State University College of Osteopathic Medicine, Conroe, TX, 77304, USA

    Ryan J. Marek

  4. Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Leslie J. Heinberg

Authors
  1. Katy W. Martin-Fernandez
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Corresponding author

Correspondence to Katy W. Martin-Fernandez.

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Conflict of interest

Yossef Ben-Porath is a paid consultant to the MMPI-2-RF publisher, the University of Minnesota Press, and distributor, Pearson Assessments. As co-author of the MMPI-2-RF, he receives royalties on sales of MMPI-2-RF materials, consulting fees, and research grants from the MMPI-2-RF publisher.

Ethics approval

The study was approved by the Cleveland Clinic’s Institutional Review Board (IRB). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Participants consented to publishing data from this study.

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Martin-Fernandez, K.W., Martin-Fernandez, J., Marek, R.J. et al. Associations among psychopathology and eating disorder symptoms and behaviors in post-bariatric surgery patients. Eat Weight Disord 26, 2545–2553 (2021). https://doi.org/10.1007/s40519-021-01111-w

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  • DOI: https://doi.org/10.1007/s40519-021-01111-w

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