A Qualitative Examination of Emotional Experiences During Physical Activity Post-metabolic/Bariatric Surgery

Feig, Emily H.; Harnedy, Lauren E.; Golden, Julia; Thorndike, Anne N.; Huffman, Jeff C.; Psaros, Christina

doi:10.1007/s11695-021-05807-x

Cited by 8 publications

(13 citation statements)

References 32 publications

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“…Recent research suggests that there are themes associated with positive affect (i.e., excitement, determination, pride, sense of accomplishment, joy) while participating in physical activity after having bariatric surgery. These themes included enjoyment of the activity itself, social connection, mindfulness, and mastery of a skill ( 99 ). Patients may find it beneficial to reconnect with physical activities that they enjoy earlier in life or perhaps engage in novel activities they have not tried yet, such as yoga or rock climbing.…”

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

“…Interestingly, a theme related to negative affect (i.e., frustration, fatigue, dislike) was all-or-nothing thinking about physical activity ( 99 ). For instance, focusing only on the negative aspects, having a general dislike of physical activity, or discounting efforts that fall short of personal goals were described as stressful and anxiety-provoking.…”

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

“…For instance, focusing only on the negative aspects, having a general dislike of physical activity, or discounting efforts that fall short of personal goals were described as stressful and anxiety-provoking. Reminding patients that while goal setting around reaching a certain frequency, intensity, or time of physical activity is useful, there are other meaningful ways to incorporate activity, like focusing on reducing sedentary behavior during leisure time and increasing light activity throughout the day ( 79 , 99 ). For patients who have sedentary work lives (e.g., telework), discussing strategies to limit or break up time spent sitting can be beneficial.…”

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

“…For patients who have sedentary work lives (e.g., telework), discussing strategies to limit or break up time spent sitting can be beneficial. Another theme that emerged as a barrier to physical activity was using weight loss as the primary motivator to be physically active ( 99 ). Considering the known benefits of physical activity beyond weight loss, such as improved metabolic health, fitness, strength, flexibility, balance, and mood enhancement, stress reduction and longevity may be helpful for some patients.…”

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

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Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery

2022

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Weight regain after bariatric surgery is associated with problematic eating behaviors that have either recurred after a period of improvement or are new-onset behaviors. Problematic eating behaviors after bariatric surgery have been conceptualized in different ways in the literature, such as having a food addiction and experiencing a loss of control of eating. The intersection of these constructs appears to be driven overeating defined as patients’ experiences of reduced control of their eating which results in overeating behavior. The purpose of this review is to define patient experiences of driven overeating through the behavioral expression of emotion-based eating, reward-based eating, and executive functioning deficits—namely impulsivity—which is associated with weight regain after having bariatric surgery. Delineating concepts in this way and determining treatment strategies accordingly may reduce distress related to the inevitable return of increased hunger, cravings, portion sizes, and tolerance for highly palatable foods after surgery. Along with standard behavioral weight maintenance strategies, topics including acceptance, motivation, emotion-based eating, reward-based/impulsive eating, physical activity, and self-compassion are discussed. These concepts have been adapted for patients experiencing weight regain after having bariatric surgery and may be particularly helpful in attenuating driven overeating and weight regain.

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Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

Section: Enhanced Behavioral Strategies For Driven Overeatingmentioning

confidence: 99%

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Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery

2022

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“…However, most people experience a decrease in positive affect during exercise [29], and sedentary women with obesity have been found to experience even lower pleasure during physical activity than those with a BMI in the normal or overweight category [30]. People undergoing bariatric surgery may be missing out on this "upward spiral" owing to emotional barriers to physical activity, such as anxiety about getting injured, shame about appearance, and experiences of weight stigma, as well as physical barriers such as increased shortness of breath and discomfort [31][32][33]. This group would benefit from new skills to increase positive affect during physical activity as well increased psychological well-being in general.…”

Section: Introductionmentioning

confidence: 99%

A Positive Emotion–Focused Intervention to Increase Physical Activity After Bariatric Surgery: Protocol for a Pilot Randomized Controlled Trial

Feig¹,

Harnedy²,

Thorndike³

et al. 2022

JMIR Res Protoc

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Background Physical activity levels after bariatric surgery are usually low, despite the significant protective health benefits of physical activity in this population. Positive psychological well-being is associated with improved adherence to health behaviors, but bariatric surgery patients often have negative associations with physical activity that prevent sustained engagement. Objective The Gaining Optimism After weight Loss Surgery (GOALS) pilot randomized controlled trial is aimed at testing a novel intervention to increase physical activity after bariatric surgery, which incorporates positive psychological skill-building with motivational interviewing and goal-setting. Methods The GOALS trial is a 2-arm, 24-week pilot randomized controlled trial that aims to enroll 58 adults who report less than 200 minutes per week of moderate to vigorous physical activity and a desire to become more active 6-12 months after bariatric surgery. GOALS is testing the feasibility, acceptability, and preliminary efficacy of a positive psychology–motivational interviewing telephone intervention targeting to increase physical activity and associated positive affect. Intervention components include positive psychology, goal-setting, self-monitoring via provided Fitbits, and motivational interviewing to overcome barriers and increase motivation. The intervention is compared to a physical activity education control that includes mailings with psychoeducation around physical activity and provision of a Fitbit. The primary outcomes of the pilot trial are feasibility and acceptability, measured as session completion rates and participant ratings of ease and helpfulness of each session. The main secondary outcome is change in accelerometer-measured moderate to vigorous physical activity post intervention and at 24-week follow-up. Additional outcomes include changes in attitudes related to physical activity, psychological well-being, and physical health measures. Results This multiphase project was funded in 2020 and institutional review board approval was obtained for the proposed trial in 2021. Recruitment for the randomized controlled trial began in July 2022. Upon completion of the pilot trial, we will examine the feasibility, acceptability, and preliminary efficacy of the intervention. Conclusions Although bariatric surgery is the most effective treatment available for severe obesity, weight regain occurs, often in the context of low psychological well-being. Many individuals would benefit from learning strategies to increase positive psychological well-being after bariatric surgery, which could help them maintain lifestyle changes. Positive psychology is a novel approach to improve adherence by increasing positive associations with health behaviors including physical activity. The GOALS pilot trial will determine whether this type of intervention is feasible and acceptable to this population and will provide a foundation for a future full-scale randomized controlled efficacy trial. Trial Registration ClinicalTrials.gov NCT04868032; https://clinicaltrials.gov/ct2/show/NCT04868032 International Registered Report Identifier (IRRID) PRR1-10.2196/39856

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Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study

Imhagen,

Karlsson,

Ohlsson-Nevo

et al. 2023

OBES SURG

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Introduction Physical activity (PA) after metabolic and bariatric surgery (MBS) can influence weight loss, health status, and quality of life. Known mediators to participate in PA are enjoyment, self-efficacy, and social support. Little is known about PA behavior in MBS individuals. The aim of this study was to explore levels of PA and the PA mediators enjoyment, self-efficacy, and social support before and after MBS and to investigate changes over time. Methods Adults scheduled to undergo MBS were recruited from a Swedish university hospital. Accelerometer-measured and self-reported PA, body weight, and PA mediators were collected at baseline and at 12 to 18 months post-surgery. Results Among 90 individuals included, 50 completed the follow-up assessment and had valid accelerometer data. Sedentary time (minutes/day) was unchanged, but sedentary time as percentage of wear time decreased significantly from 67.2% to 64.5% (p<0.05). Time spent in light PA and total PA increased significantly from 259.3 to 288.7 min/day (p < 0.05) and from 270.5 to 303.5 min/day (p < 0.01), respectively. Step counts increased significantly from 6013 to 7460 steps/day (p < 0.01). There was a significant increase in self-reported PA, enjoyment, self-efficacy for exercise, and positive social support from family. The increase in PA mediators did not lead to a significant change in time spent in moderate to vigorous PA. Conclusion The increase in PA-mediators was not associated with an increase in moderate to vigorous PA, but the strengthened PA mediators suggest potential for an increase in moderate to vigorous PA in patients undergoing MBS. Graphical abstract

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A Qualitative Examination of Emotional Experiences During Physical Activity Post-metabolic/Bariatric Surgery

Cited by 8 publications

References 32 publications

Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery

Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery

A Positive Emotion–Focused Intervention to Increase Physical Activity After Bariatric Surgery: Protocol for a Pilot Randomized Controlled Trial

Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study

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