Emotional Regulation Underlies Gender Differences in Pathological Eating Behavior Styles of Bariatric Surgery Candidates

Abstract

Almost a third of bariatric surgery patients present suboptimal weight loss or important weight regain in the first five postoperative years. While the reasons underlying this are not fully understood, it is known that pathological eating styles (such as emotional or binge eating) can thwart efforts to maintain weight loss. However, detailed characterization and understanding of these eating styles have yet to be achieved. In particular, research on gender differences in pathological eating styles and psychiatric symptoms before bariatric surgery is lacking. To characterize gender differences in eating styles and their association with clinical symptoms, we prospectively enrolled 110 bariatric surgery candidates, collecting eating styles and clinical scores. Women displayed a higher frequency of emotional eating as compared to men (x2 = 9.07, p = 0.003), while men showed a higher frequency of quantitative eating behavioral style (x2 = 4.58, p = 0.044). Binge eating style was associated with higher Difficulties in Emotion Regulation Scale (DERS), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) scores (p < 0.05). Emotional eating style was associated with higher HAM-D and HAM-A scores (p < 0.05). The present findings highlight the importance of understanding the role of gender differences in emotion regulation processes involved in the development and maintenance of pathological eating styles in bariatric surgery candidates. This paves the way to gender- and symptoms-specific interventions on eating behaviors to improve surgery long-term outcomes.

Bariatric Surgery Reduces Weight Loss, Comorbidities Prevalence, and Improves Quality of Life in the Southern Region of Saudi Arabia

“…Although the present study indicates significant weight loss, the short period is insufficient to determine whether participants can maintain the desired body weight. According to Saccaro [29], disordered eating behavior, such as emotional eating, can reverse the effects of dietary recommendations and surgical interventions in the long term, which are critical to maintaining weight loss and adherence to a healthy post-surgical diet. Despite bariatric surgical procedures limiting food intake and leasing to maladaptive nutrient absorption in the stomach and the more extensive digestive system, continued dieting is crucial to the maintenance of weight loss.…”

Emotion dysregulation links pathological eating styles and psychopathological traits in bariatric surgery candidates

“…Increasing evidence suggests that insecure attachment plays a crucial role in the development of obesity ( 15 ). Research indicates that insecure attachment, either anxious and avoidant, is positively associated with emotion dysregulation and can predict disordered eating behaviors, particularly in women ( 16 , 17 ). In this regard, attachment history could be a key factor to consider in the prevention and treatment of overweight and obesity.…”