Negative Affect and Loss of Control Eating Among Bariatric Surgery Patients: an Ecological Momentary Assessment Pilot In
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ORIGINAL CONTRIBUTIONS
Negative Affect and Loss of Control Eating Among Bariatric Surgery Patients: an Ecological Momentary Assessment Pilot Investigation Gail A. Williams-Kerver 1
&
Kristine J. Steffen 1,2 & Kathryn E. Smith 1,3 & Li Cao 1 & Ross D. Crosby 1 & Scott G. Engel 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Research shows that loss of control (LOC) eating impacts weight outcomes following bariatric surgery, but mechanisms explaining the development and/or maintenance of post-surgical LOC eating remain unclear. Ecological momentary assessment (EMA) research among eating disorder populations has demonstrated prospective relationships between negative affect (NA) and LOC eating; however, this momentary effect has not been examined among bariatric surgery patients. Thus, this study used EMA data to examine momentary relationships between NA and LOC eating among pre- and post-bariatric surgery patients. Methods Fourteen pre- and 17 post-RYGB patients completed 2 weeks of EMA data collection. Participants responded to seven signals daily wherein they rated their mood and severity of LOC eating. Results Higher momentary NA predicted more severe LOC eating for all participants. Group had a moderating effect, demonstrating that the association between NA and LOC eating was stronger among the post-surgery group. Percent total body weight loss (%TBWL) had a moderating effect within the post-surgery group, demonstrating that the relationship between NA and LOC eating was stronger for those who experienced less weight loss. Finally, between-subjects analyses revealed that, for individuals with lower %TBWL, lower overall NA and higher overall positive affect (PA) were related to greater LOC eating. Conclusions This research demonstrates that affect influences the effect of LOC eating on weight loss following bariatric surgery. While further work is needed to extend these preliminary findings, this research suggests that affective experience might become an important target in the assessment and treatment of LOC eating among bariatric patients. Keywords Bariatric surgery . Ecological momentary assessment (EMA) . Loss of control (LOC) eating . Negative affect . Weight loss While bariatric surgery often results in substantial weight loss, a subset of patients experiences poor weight loss or weight regain following surgery [1–3]. One potential explanatory mechanism for poor weight-related outcomes after surgery is loss of control (LOC) eating and, consequently, the investigation into LOC eating as a possible psychosocial predictor of
* Gail A. Williams-Kerver [email protected] 1
Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND 58122, USA
2
Department of Pharmaceutical Sciences, North Dakota State University, PO Box 6050, Fargo, ND 58108-6050, USA
3
Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street #2200, Los Angeles, CA 90033, USA
poor weight outcomes has gro
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