Objective In the present study, we focused on the associations between identity processes/statuses and eating and general psychopathology and coping in prebariatric patients suffering from morbid obesity. Method Our sample consisted of 369 prebariatric patients (68.8% female) who filled out self‐report questionnaires to assess identity processes, eating and general psychopathology, and coping. Results Concerning identity processes, ruminative exploration was positively related to eating‐related and general psychopathology and maladaptive coping, whereas commitment processes were protective against psychopathology and maladaptive coping. Based on cluster analyses, we identified five identity statuses, being achievement, foreclosure, moratorium, diffusion, and an undifferentiated status, showing some heterogeneity within the prebariatric patient group. Patients in the diffused and moratorium statuses reported more eating and general psychopathology and more maladaptive coping compared with prebariatric patients of the other statuses. Conclusions Given the clinical vulnerability to psychopathology of patients in the moratorium and diffused statuses, it would be advisable to increase the psychological help in their prebariatric and postbariatric trajectories.

Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients; the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.

Obesity is associated with high levels of psychopathology, especially among those who engage in binge eating. Patients with binge eating also report poorer long term outcomes after bariatric surgery than patients without binge eating. However, the mechanisms underlying binge eating need further investigation. The present study investigates the relationship between identity issues and the functionality of (binge) eating behaviors in bariatric surgery candidates. Results showed that pre-bariatric patients who engage in binge eating scored higher on identity confusion compared to patients without binge eating, but no difference was found for identity synthesis. Concerning the relationship between the functions of eating and identity processes, we found a positive relationship between identity confusion and external and emotional eating in patients with binge eating, but no significant relationships were found for identity synthesis. Clinical implications and suggestions for future research are discussed.