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Examining Weight Bias and Loss-of-Control Eating among Individuals Seeking Bariatric Surgery

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Abstract

Objective

Externalized weight bias (EWB), directed towards others, and internalized weight bias (IWB), directed towards the self, are thought to exacerbate obesity and disordered eating and may be important factors to assess and understand among individuals seeking bariatric surgery. This study examined clinical correlates (pre-surgical BMI, depressive symptoms, weight self-efficacy, and shape/weight overvaluation) of both EWB and IWB among individuals presenting for bariatric surgery with and without regular loss-of-control eating (LOC eating).

Methods

A total of 316 adults presenting for bariatric surgery completed established self-report measures to assess EWB, IWB, depressive symptoms, weight self-efficacy, and core symptoms of disordered eating including LOC eating and overvaluation of shape/weight.

Results

IWB and EWB were not associated with pre-surgical BMI, age, or sex, but were both significantly higher among White than non-White participants. Adjusting for race, IWB and EWB were significantly associated with greater eating disorder psychopathology and depressive symptoms and with less weight-related self-efficacy. Participants who endorsed regular LOC eating (53.5% of the sample) endorsed significantly lower weight self-efficacy and higher IWB, EWB, depressive symptoms, and overvaluation of shape/weight.

Conclusions

Findings suggest that regular LOC eating is common among individuals seeking bariatric surgery and associated with a range of heightened eating disorder and psychosocial concerns including both IWB and EWB. Future research exploring the longitudinal significance of the relationship between these two forms of weight bias and LOC eating is indicated.

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Acknowledgements

We would like to thank Dr. Olivia Fondoble for allowing us access to her patients to conduct this study and Christina Reed, RN for help recruiting patients.

Funding

This research was supported, in part, by NIH grants R01 DK098492 and R01 DK126637.

Author information

Authors and Affiliations

  1. Psychiatry Department, Yale School of Medicine, New Haven, CT, 06511, USA

    Jessica L. Lawson, Carlos M. Grilo & Valentina Ivezaj

  2. VA Connecticut Healthcare System, West Haven, CT, 06516, USA

    Jessica L. Lawson

  3. St. Vincent Bariatric Center, Ascension St. Vincent Carmel Hospital, Carmel, IN, 46032, USA

    Leslie M. Schuh & David B. Creel

  4. Bariatric & Metabolic Institute, Cleveland Clinic, Cleveland, OH, 44195, USA

    David B. Creel

  5. Quinnipiac University, Hamden, CT, 06518, USA

    Rebecca M. Blackinton & Stefanie A. Giambrone

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  1. Jessica L. Lawson
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  2. Leslie M. Schuh
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  7. Valentina Ivezaj
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Corresponding author

Correspondence to Valentina Ivezaj.

Ethics declarations

Informed consent was obtained from all individual participants included in the study. All procedures performed in the study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of Interest

Jessica L. Lawson, PhD—no conflict of interest

Leslie M. Schuh, PhD—no conflict of interest

David B. Creel, PhD, RD, CDE—no conflict of interest

Rebecca M. Blackinton, BS—no conflict of interest

Stefanie A. Giambrone, BS—no conflict of interest

Carlos M. Grilo, PhD—reports grants from National Institutes of Health (NIH/NIDDK), during the conduct of the study; personal fees from Sunovion, personal fees from Weight Watchers, other from Guilford Press, other from Taylor and Francis Publishers, personal fees from CME, outside the submitted work.

Valentina Ivezaj, PhD—no conflict of interest

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Rebecca M. Blackinton and Stefanie A. Giambrone were affiliated with the institution while collaborating on this work.

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Lawson, J.L., Schuh, L.M., Creel, D.B. et al. Examining Weight Bias and Loss-of-Control Eating among Individuals Seeking Bariatric Surgery. OBES SURG 31, 3498–3505 (2021). https://doi.org/10.1007/s11695-021-05418-6

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