Tosca D Braun1,2,3, Amy A Gorin4, Rebecca M Puhl5, Andrea Stone6, Diane M Quinn4, Jennifer Ferrand7, Ana M Abrantes8,9, Jessica Unick8,10, Darren Tishler6, Pavlos Papasavas6. 1. Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA. tosca_braun@brown.edu. 2. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. tosca_braun@brown.edu. 3. Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, CT, USA. tosca_braun@brown.edu. 4. Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, & Policy, University of Connecticut, Storrs, CT, USA. 5. Department of Human Development & Family Sciences, Rudd Center for Food Policy & Obesity, University of Connecticut, Storrs, CT, USA. 6. Surgical Weight Loss Center, Hartford Hospital, Glastonbury, USA. 7. Institute of Living, Div. of Health Psychology, Hartford Hospital, Hartford, CT, USA. 8. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. 9. Behavioral Medicine and Addiction Research, Butler Hospital, Providence, RI, USA. 10. Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, USA.
Abstract
BACKGROUND: Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias and internalized weight bias (IWB) may associate with emotional eating among individuals seeking bariatric surgery. METHODS: We examined associations of experienced weight bias, IWB, shame, self-compassion, and emotional eating in patients from a surgical weight loss clinic (N = 229, 82.1% female, M. BMI: 48 ± 9). Participants completed a survey of validated self-report measures that were linked to BMI from the patient medical record. Multiple regression models tested associations between study constructs while PROCESS bootstrapping estimates tested the following hypothesized mediation model: IWB ➔ internalized shame ➔ self-compassion ➔ emotional eating. Primary analyses controlled for adverse childhood experiences (ACE), a common confound in weight bias research. Secondary analyses controlled for depressive/anxiety symptoms from the patient medical record (n = 196). RESULTS: After covariates and ACE, each construct accounted for significant unique variance in emotional eating. However, experienced weight bias was no longer significant and internalized shame marginal, after controlling for depressive/anxiety symptoms. In a mediation model, IWB was linked to greater emotional eating through heightened internalized shame and low self-compassion, including after controlling for depressive/anxiety symptoms. CONCLUSIONS: Pre-bariatric surgery, IWB may signal risk of emotional eating, with potential implications for post-operative trajectories. Self-compassion may be a useful treatment target to reduce IWB, internalized shame, and related emotional eating in bariatric surgery patients. Further longitudinal research is needed.
BACKGROUND: Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias and internalized weight bias (IWB) may associate with emotional eating among individuals seeking bariatric surgery. METHODS: We examined associations of experienced weight bias, IWB, shame, self-compassion, and emotional eating in patients from a surgical weight loss clinic (N = 229, 82.1% female, M. BMI: 48 ± 9). Participants completed a survey of validated self-report measures that were linked to BMI from the patient medical record. Multiple regression models tested associations between study constructs while PROCESS bootstrapping estimates tested the following hypothesized mediation model: IWB ➔ internalized shame ➔ self-compassion ➔ emotional eating. Primary analyses controlled for adverse childhood experiences (ACE), a common confound in weight bias research. Secondary analyses controlled for depressive/anxiety symptoms from the patient medical record (n = 196). RESULTS: After covariates and ACE, each construct accounted for significant unique variance in emotional eating. However, experienced weight bias was no longer significant and internalized shame marginal, after controlling for depressive/anxiety symptoms. In a mediation model, IWB was linked to greater emotional eating through heightened internalized shame and low self-compassion, including after controlling for depressive/anxiety symptoms. CONCLUSIONS: Pre-bariatric surgery, IWB may signal risk of emotional eating, with potential implications for post-operative trajectories. Self-compassion may be a useful treatment target to reduce IWB, internalized shame, and related emotional eating in bariatric surgery patients. Further longitudinal research is needed.
Authors: Natalie G Keirns; Bryant H Keirns; Cindy E Tsotsoros; Christina M Sciarrillo; Sam R Emerson; Misty A W Hawkins Journal: Stigma Health Date: 2022-05
Authors: Natalie G Keirns; Cindy E Tsotsoros; Samantha Addante; Harley M Layman; Jaimie Arona Krems; Rebecca L Pearl; A Janet Tomiyama; Misty A W Hawkins Journal: Obesities Date: 2021-06-03
Authors: Tosca D Braun; Kristen E Riley; Zachary J Kunicki; Lucy Finkelstein-Fox; Lisa A Conboy; Crystal L Park; Elizabeth Schifano; Ana M Abrantes; Sara W Lazar Journal: Health Psychol Behav Med Date: 2021-11-19
Authors: Christina M Hopkins; Hailey N Miller; Taylor L Brooks; Lihua Mo-Hunter; Dori M Steinberg; Gary G Bennett Journal: JMIR Res Protoc Date: 2021-11-25