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Obes Surg. 2004 Nov-Dec;14(10):1402-5.

Self-assessed emotional factors contributing to increased weight gain in pre-surgical bariatric patients.

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The Atlanta Center for Cognitive Therapy and Georgia State University, Atlanta, GA 30345, USA.



One important part of the pre-surgical mental health evaluation is to assess what, if any, emotional factors may be related to a patient's eating behavior. In this way, appropriate biopsychosocial interventions may be designed to facilitate their long-term maintenance of weight loss. The current investigation examined the role that negative emotional states might play in increased pre-surgical eating behavior in a sample of bariatric surgery patients.


A sample of 122 female patients completed the Weight and Lifestyle Inventory as a component of a comprehensive psychological evaluation. This questionnaire contains 6 items that assess the degree of 6 negative emotional states. These data were examined to determine which negative emotional states were most frequently related to increased eating behavior. In addition, the frequency of reporting multiple emotional contributors to eating was also examined.


Eating when stressed received the highest scores, followed by eating when bored, eating when depressed, eating when anxious, eating when angry, and eating when tired. A large segment (38%) of the sample indicated that emotional factors did not contribute a large amount to their increased weight gain, while on the other hand, a large segment (40%) could be identified as "emotional eaters."


To increase the likelihood of long-term maintenance of weight loss, a significant portion of this patient population would benefit from interventions targeting overcoming boredom, reducing stress, and managing depression. In the pre-surgical evaluation, it is important to identify those patients who are "emotional eaters" and to refer them for appropriate interventions.

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