Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates

• Published in: Journal of eating disorders 2021-11, Vol.9 (1), p.1-148, Article 148
• Main Authors: Benzerouk, Farid, Guénin, Monique, Gierski, Fabien, Raucher-Chéné, Delphine, Barrière, Sarah, Bertin, Eric, Kaladjian, Arthur
• Format: Article
• Language: English
• Subjects: (Lack of) perseverance; Analysis; Anxiety; Bariatric surgery; Body weight; Comorbidity; Depression, Mental; Eating behavior; Emotions; Food habits; Health aspects; Impulsivity; Life Sciences; Mediation; Mental depression; Obesity; Surgery; Thoughts; Urgency
• ISSN: 2050-2974; 0276-3478; 2050-2974; 1098-108X
• DOI: 10.1186/s40337-021-00503-8

Background Even if bariatric surgery is considered the most effective therapeutic approach, it is not equally successful among individuals suffering from severe obesity and candidates for this weight loss surgery. Among the factors that influence postsurgical outcomes, eating behaviors styles are known to play a key role in relapses. The aim of our study was to assess eating behaviors styles and several modulating psychopathological factors in patients suffering from severe obesity. Methods Patients seeking bariatric surgery (N = 127) completed a set of standardized tools assessing eating behaviors (Dutch Eating Behavior Questionnaire), comorbid psychiatric conditions (Mini International Neuropsychiatric Interview), depression, and anxiety scores (Beck Depression Inventory, State-Trait Anxiety Inventory), and impulsivity scores (UPPS-P Impulsive Behavior Scale). Results We detected significant correlations between DEBQ Emotional Eating (EmoE) and depression, state and trait anxiety, and all dimensions of impulsivity. Significant correlations were also present between DEBQ External Eating (ExtE) and depression, state and trait anxiety and UPPS-P positive urgency, lack of perseverance and sensation seeking. Regression analyses identified sex (female), trait anxiety, and lack of perseverance as explanatory factors for EmoE, and depression severity score and positive urgency for ExtE. Conclusions EmoE might be a means of dealing with negative emotions and/or intrusive thoughts, while ExtE might result from a mechanism associated with depression. These results should help to improve patients' outcomes by defining specific therapeutic targets in psychological interventions. Plain English summary After bariatric surgery, some patients regain weight. This is likely due to various factors, including a return of maladaptive eating styles, such as emotional eating (which occurs as a response to negative emotions, like depression, anxiety, anger, sadness, and discouragement), external eating (which refers to the tendency to eat in response to positive external cues, regardless of internal signals of hunger and satiety), and restraint eating (implying to make efforts to develop and maintain strategies to control calories intake, associated with weight loss after lifestyle intervention). Our goal in this research project was to explore associated factors (particularly depression, anxiety, and impulsivity) to these eating styles in patients suffering from obesity prior t