Internalized weight bias and loss-of-control eating following bariatric surgery

doi:10.1080/10640266.2020.1731920

. 2021 Nov-Dec;29(6):630-643.

doi: 10.1080/10640266.2020.1731920. Epub 2020 Mar 17.

Internalized weight bias and loss-of-control eating following bariatric surgery

Jessica L Lawson^{1

2}, Abigail LeCates³, Valentina Ivezaj², Janet Lydecker², Carlos M Grilo^{2

4}

Affiliations

¹ Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
² Psychiatry Department, Yale School of Medicine, New Haven, Connecticut, USA.
³ Psychology Department, Amherst College, Amherst, Massachusetts, USA.
⁴ Psychiatry Department, Yale University, New Haven, Connecticut, USA.

PMID: 32182194
PMCID: PMC7494529
DOI: 10.1080/10640266.2020.1731920

Internalized weight bias and loss-of-control eating following bariatric surgery

Jessica L Lawson et al. Eat Disord. 2021 Nov-Dec.

. 2021 Nov-Dec;29(6):630-643.

doi: 10.1080/10640266.2020.1731920. Epub 2020 Mar 17.

Authors

Jessica L Lawson^{1

2}, Abigail LeCates³, Valentina Ivezaj², Janet Lydecker², Carlos M Grilo^{2

4}

Affiliations

¹ Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
² Psychiatry Department, Yale School of Medicine, New Haven, Connecticut, USA.
³ Psychology Department, Amherst College, Amherst, Massachusetts, USA.
⁴ Psychiatry Department, Yale University, New Haven, Connecticut, USA.

PMID: 32182194
PMCID: PMC7494529
DOI: 10.1080/10640266.2020.1731920

Abstract

Objective: Internalized weight bias (IWB), or negative weight related self-evaluation, is associated with eating-disorder psychopathology and common among patients seeking bariatric surgery, but little is known about the clinical presentation of IWB post-operatively. This study examined IWB and clinical correlates among adult patients with loss-of-control (LOC) eating post-sleeve gastrectomy surgery.

Methods: Participants (N = 145) were sleeve gastrectomy patients seeking treatment for eating/weight concerns and experiencing regular LOC eating approximately 6 months following surgery. Eating-disorder features were assessed with the Eating Disorder Examination-Bariatric Surgery Version interview (EDE-BSV) and participants completed established measures assessing IWB, depression, and mental and physical components of quality of life.

Results: IWB was not associated significantly with percent excess weight loss, age, or gender, but White participants reported significantly greater IWB than Non-White participants. IWB was significantly associated with greater eating-disorder psychopathology, depression, and lower perceived mental quality of life. Hierarchical regression analysis revealed that IWB significantly predicted variance in eating-disorder psychopathology above and beyond other related variables.

Conclusions: Findings suggest that IWB is common and associated with a range of heightened eating-disorder and psychosocial difficulties among patients experiencing LOC eating following bariatric surgery. Future research exploring the longitudinal post-operative prognostic significance of IWB is recommended.

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Conflict of interest statement

The authors declare no conflicts of interest. Outside the submitted work, Dr. Grilo reports grants from National Institutes of Health, personal fees from Sunovion, Shire, and Weight Watchers International, and royalties from Guilford Press and Taylor and Francis Publishing.

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References

1. Ashmore JA, Friedman KE, Reichmann SK, & Musante GJ (2008). Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults. Eat Behav, 9(2), 203–209. doi:10.1016/j.eatbeh.2007.09.006 - DOI - PubMed
1. Baldofski S, Rudolph A, Tigges W, Herbig B, Jurowich C, Kaiser S, … Hilbert A (2016). Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patients. Int J Eat Disord, 49(2), 180–185. doi:10.1002/eat.22484 - DOI - PubMed
1. Barnes RD, Ivezaj V, & Grilo CM (2014). An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder. Gen Hosp Psychiatry, 36(2), 177–180. doi:10.1016/j.genhosppsych.2013.10.011 - DOI - PMC - PubMed
1. Beck AS, R A; Brown GK (1996). Beck depression inventory-second edition manual. San Antonio: Psychological Corporation.
1. Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, … Kothari S (2015). Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg, 25(4), 587–606. doi:10.1007/s11695-015-1645-3 - DOI - PubMed

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[1] Ashmore JA, Friedman KE, Reichmann SK, & Musante GJ (2008). Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults. Eat Behav, 9(2), 203–209. doi:10.1016/j.eatbeh.2007.09.006 - DOI - PubMed

[2] Ashmore JA, Friedman KE, Reichmann SK, & Musante GJ (2008). Weight-based stigmatization, psychological distress, & binge eating behavior among obese treatment-seeking adults. Eat Behav, 9(2), 203–209. doi:10.1016/j.eatbeh.2007.09.006 - DOI - PubMed

[3] Baldofski S, Rudolph A, Tigges W, Herbig B, Jurowich C, Kaiser S, … Hilbert A (2016). Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patients. Int J Eat Disord, 49(2), 180–185. doi:10.1002/eat.22484 - DOI - PubMed

[4] Baldofski S, Rudolph A, Tigges W, Herbig B, Jurowich C, Kaiser S, … Hilbert A (2016). Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patients. Int J Eat Disord, 49(2), 180–185. doi:10.1002/eat.22484 - DOI - PubMed

[5] Barnes RD, Ivezaj V, & Grilo CM (2014). An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder. Gen Hosp Psychiatry, 36(2), 177–180. doi:10.1016/j.genhosppsych.2013.10.011 - DOI - PMC - PubMed

[6] Barnes RD, Ivezaj V, & Grilo CM (2014). An examination of weight bias among treatment-seeking obese patients with and without binge eating disorder. Gen Hosp Psychiatry, 36(2), 177–180. doi:10.1016/j.genhosppsych.2013.10.011 - DOI - PMC - PubMed

[7] Beck AS, R A; Brown GK (1996). Beck depression inventory-second edition manual. San Antonio: Psychological Corporation.

[8] Beck AS, R A; Brown GK (1996). Beck depression inventory-second edition manual. San Antonio: Psychological Corporation.

[9] Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, … Kothari S (2015). Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg, 25(4), 587–606. doi:10.1007/s11695-015-1645-3 - DOI - PubMed

[10] Brethauer SA, Kim J, El Chaar M, Papasavas P, Eisenberg D, Rogers A, … Kothari S (2015). Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg, 25(4), 587–606. doi:10.1007/s11695-015-1645-3 - DOI - PubMed

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Internalized weight bias and loss-of-control eating following bariatric surgery

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Internalized weight bias and loss-of-control eating following bariatric surgery

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