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- Title
Shame and Self-compassion as Risk and Protective Mechanisms of the Internalized Weight Bias and Emotional Eating Link in Individuals Seeking Bariatric Surgery.
- Authors
Braun, Tosca D.; Gorin, Amy A.; Puhl, Rebecca M.; Stone, Andrea; Quinn, Diane M.; Ferrand, Jennifer; Abrantes, Ana M.; Unick, Jessica; Tishler, Darren; Papasavas, Pavlos
- Abstract
Background: Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias and internalized weight bias (IWB) may associate with emotional eating among individuals seeking bariatric surgery. Methods: We examined associations of experienced weight bias, IWB, shame, self-compassion, and emotional eating in patients from a surgical weight loss clinic (N = 229, 82.1% female, M. BMI: 48 ± 9). Participants completed a survey of validated self-report measures that were linked to BMI from the patient medical record. Multiple regression models tested associations between study constructs while PROCESS bootstrapping estimates tested the following hypothesized mediation model: IWB ➔ internalized shame ➔ self-compassion ➔ emotional eating. Primary analyses controlled for adverse childhood experiences (ACE), a common confound in weight bias research. Secondary analyses controlled for depressive/anxiety symptoms from the patient medical record (n = 196). Results: After covariates and ACE, each construct accounted for significant unique variance in emotional eating. However, experienced weight bias was no longer significant and internalized shame marginal, after controlling for depressive/anxiety symptoms. In a mediation model, IWB was linked to greater emotional eating through heightened internalized shame and low self-compassion, including after controlling for depressive/anxiety symptoms. Conclusions: Pre-bariatric surgery, IWB may signal risk of emotional eating, with potential implications for post-operative trajectories. Self-compassion may be a useful treatment target to reduce IWB, internalized shame, and related emotional eating in bariatric surgery patients. Further longitudinal research is needed.
- Subjects
EMOTIONAL eating; BARIATRIC surgery; ADVERSE childhood experiences; GASTRIC bypass; SHAME; PATH analysis (Statistics); FOOD habits
- Publication
Obesity Surgery, 2021, Vol 31, Issue 7, p3177
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-021-05392-z