Page 114 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg

114 Chapter 6
reward sensitivity and insufficient response inhibition, have been linked to obesity [30]. On a behavioral level, people with a higher level of impulsivity tend to eat more unhealthy foods [31]. The review by Schag and colleagues (2013) showed that impul- sivity in obese patients mainly expresses itself in disordered eating behaviors by loss of control over eating [32]. It has also been suggested that impulsivity has an indirect negative impact on weight loss after BS that is mediated by depression for instance when being in a negative mood enhances impulsivity and thus leads to impulsive overeating [15]. Obese people showed more disordered eating behaviors especially when they experience a negative mood [33]. The study by Schag and colleagues (2016) showed that impulsivity and depressive symptoms both are associated with disor- dered eating behaviors [15].
According to previous research the prevalence of psychopathology in bariatric patients is approximately 50% [7, 34-36]. Psychopathology seems to be related with post-operative weight loss [37]. Successful or suboptimal post-operative weight loss is associated with the degree to which patients benefited from previous psychological treatment.
The aim of this study was to develop a better understanding of which post- operative behavioral and psychological factors are associated with suboptimal weight loss after BS.
In addition, we examined whether better weight loss in the first six months was associated with better weight outcome on long-term. We also explored the factors; pre-operative super-obesity, age and gender were associated to subopti- mal weight loss. We hypothesized that post-operative eating disorder pathology, depression and impulsivity were associated with suboptimal weight loss after BS.
Methods
Participants
Participants were recruited through advertising on online Dutch platforms devel- oped for bariatric peer support. In addition, recruitment by advertising took place through Dutch general hospitals where BS is performed. Finally, eligible patients of an eating disorder treatment center were invited by health professionals to partic- ipate. In total, 129 of the 140 (92%) participants were recruited through online platforms and general hospitals and 11 of the 140 (8%) participants were recruited through an eating disorder treatment center.