Associations Between Approach and Avoidance Coping, Psychological Distress, and Disordered Eating Among Candidates for Bariatric Surgery

Background Individuals seeking bariatric surgery evidence risk for binge and disordered eating behaviors, which can lead to poorer post-surgical weight loss outcomes. Use of avoidant coping strategies to manage stress, along with symptoms of depression, are associated with disordered eating in the g...

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Bibliographic Details
Published in:Obesity surgery 2019-11, Vol.29 (11), p.3596-3604
Main Authors: McGarrity, Larissa A., Perry, Nicholas S., Derbidge, Christina M., Trapp, Stephen K., Terrill, Alexandra L., Smith, Timothy W., Ibele, Anna R., MacKenzie, Justin J.
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adult
Anxiety - epidemiology
Avoidance Learning
Bariatric Surgery
Bulimia
Coping
Cross-Sectional Studies
Depression - epidemiology
Depression - psychology
Feeding and Eating Disorders - epidemiology
Female
Gastrointestinal surgery
Humans
Male
Medicine
Medicine & Public Health
Mental depression
Middle Aged
Obesity
Obesity, Morbid - psychology
Obesity, Morbid - surgery
Original Contributions
Psychological Distress
Surgery
Weight Loss
Young Adult
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Summary:Background Individuals seeking bariatric surgery evidence risk for binge and disordered eating behaviors, which can lead to poorer post-surgical weight loss outcomes. Use of avoidant coping strategies to manage stress, along with symptoms of depression, are associated with disordered eating in the general population. However, the role of coping has not been examined among candidates for bariatric surgery, and coping and depression have rarely been considered in combination. Given the emerging standard that psychologists are involved in evaluations and treatment before and after surgery, consideration of these variables is clinically relevant. Methods Participants were 399 patients undergoing pre-surgical bariatric psychological assessment. Hierarchical linear regression analyses tested whether gender, age, and BMI; approach and avoidance coping; and depression and anxiety were associated with disordered eating (binge eating, restraint, eating concerns, shape concerns, weight concerns) in a cross-sectional study design. Results In initial steps of the model controlling demographic variables, approach coping predicted less and avoidance coping predicted more disordered eating across most outcomes examined. In models including depression and anxiety, avoidance (but not approach) coping remained a relevant predictor. The effects of depression were also quite robust, such that participants who were more depressed reported more disordered eating. More anxious participants reported more restrained eating. Conclusions Avoidance coping and depressive symptoms emerged as key variables in understanding recent disordered eating among patients considering bariatric surgery. Pre-surgical psychological evaluations and treatment approaches could be enhanced with consideration of patient coping strategies, particularly avoidant coping responses to stress, independent of psychological distress.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-019-04038-5