ABSTRACT
People often fail to acknowledge external influences on their food intake, but there might be some circumstances in which people are willing to report that those external factors influenced their behavior. This study examined whether participants who believed that they had overeaten would indicate that the portion size they were served influenced their food intake. Participants (119 women) ate a pasta lunch at two separate sessions, one week apart. At the second session, participants were randomly assigned to receive either a regular portion of pasta (the same portion as the first session) or a large portion of pasta (a portion that was twice the size), and to receive false feedback about their food intake indicating that they had either eaten about the same as or substantially more than they had at the previous session. Participants were then asked to indicate the extent to which the amount of food served influenced how much they ate at that second session. Compared to participants who were informed that they had eaten the same amount across the two sessions, those who were informed that they ate more at the second session reported a stronger influence of the amount of food served if they also received a large portion of pasta, but not if they received a regular portion of pasta. These findings suggest that the willingness to implicate external influences (e.g., portion size) on one's food intake may be driven by a self-serving bias, providing an "excuse" for overeating. However, the external cue must be salient enough to be a plausible explanation for one's behavior.
Subject(s)
Eating , Feeding Behavior , Portion Size , Humans , Female , Young Adult , Adult , Portion Size/psychology , Feeding Behavior/psychology , Eating/psychology , Adolescent , Hyperphagia/psychology , Male , Energy Intake , LunchABSTRACT
The Identity Disruption Model posits that early adversity is associated with lower self-concept clarity, which in turn increases vulnerability to sociocultural appearance factors and body dissatisfaction, but this model has not previously been tested among adolescents. Testing the model during adolescence is critical because this is a key point of development of both identity and body dissatisfaction. This paper presents two studies with adolescents recruited through social media (Study 1: n = 213; 78% female; mean age = 15.7 years, SD = 1.14) and from high schools (Study 2; n = 228; 43% female; mean age = 13.8 years, SD = 1.15). In both studies, self-reported early adversity was associated with lower self-concept clarity; lower self-concept clarity was associated with greater internalization of appearance ideals and more frequent appearance comparisons; and internalization and appearance comparisons were associated with greater body dissatisfaction. This research builds on previous sociocultural models of body dissatisfaction by pointing to processes that occur early in life that could be potential targets of intervention and prevention efforts.
Subject(s)
Adverse Childhood Experiences , Body Dissatisfaction , Humans , Female , Adolescent , Male , Body Image , Surveys and Questionnaires , Self ConceptABSTRACT
The social facilitation of eating refers to people's tendency to eat more food when dining with others than when dining alone. Recent research suggests that social facilitation may be driven by people's tendency to make more food available even before social meals begin, a phenomenon referred to as social "precilitation." In order to uncover the mechanisms underlying social precilitation, it is helpful to first understand whether people consciously and deliberately make more food available for social meals. Three studies (total N = 792) used an online serving paradigm to investigate this question. Participants were asked to imagine dining alone and dining socially, and indicated how much food they would serve themselves in each scenario. Unexpectedly, participants consistently reported intending to serve themselves smaller portions for social meals than for non-social meals (Study 1). This effect emerged even when they were asked about how someone else would behave (Study 2), and when they were informed that there was plenty of food available at the social meal (Study 3). This research highlights a disconnect between people's intended serving behaviour and the actual serving behaviour observed in laboratory studies, and suggests that people may not be aware of how their behaviour is influenced by the social context. Future research should examine why the disconnect between people's intended and actual serving behaviour occurs, whether it is related to the amount of food provided for social meals, and what implications the disconnect has for people's ability to manage their food intake.
Subject(s)
Eating , Portion Size , Humans , Meals , AwarenessABSTRACT
People eat more when they eat a meal with familiar others than they do when eating alone. However, it is unknown whether eating socially impacts intake over the longer-term. The aim of Study 1 was to examine whether socially facilitated intake is sustained across all meals and across three consecutive days. The aim of Study 2 was to examine whether increased intake during a social meal taken in the laboratory is compensated for under free-living conditions. In Study 1, adult women (n = 26) ate all their meals across three days either with a friend or alone in a counterbalanced cross-over design. In Study 2 adult women (n = 63) consumed a meal in the laboratory either alone or with two friends and then recorded everything they ate and drank for the next three days using electronic food diary software. In Study 1 intake across 3 days was significantly greater in the Social (M = 7310 kcal, SD = 1114) than in the Alone condition (M = 6770 kcal, SD = 974) (F(1,423) = 16.10, p < .001, d = 0.51). In Study 2 participants consumed significantly more in the laboratory when eating with their friends (M = 1209 kcal, SD = 340) than when eating alone (M = 962 kcal, SD = 301) (F(1,63) = 13.28, p = .001, d = 0.77). Analysis of food diary data plus laboratory intake showed that intake remained significantly greater in the Social (M = 6396 kcal, SD = 1470) than in the Alone condition after 4 days (M = 5776 kcal, SD = 1182) (F(1,59) = 5.59, p = .021, d = 0.05). These results show that social facilitation of eating is sustained over three days and suggest that people fail to compensate for the social facilitation of eating.
Subject(s)
Social Conditions , Social Facilitation , Adult , Cross-Over Studies , Eating , Energy Intake , Female , Humans , MealsABSTRACT
Social modeling is a powerful influence on people's food intake: When there is a clear and consistent norm, people eat more when eating with someone who eats a lot and eat less when eating with someone who eats only a little. In three studies, the present research examined how clear versus ambiguous social-normative information influences the modeling of food-related decisions. Using a novel online decision-making paradigm, female participants (total N = 1042) were provided with information about how many cookies previous participants had supposedly selected (no information was provided in the control condition), and then decided how many cookies they would choose for a snack. When there was a clear and consistent norm, the typical social modeling effect was observed. When there was a small number of "dissenters" whose responses conflicted with the norm set by the majority, participants' cookie selection still conformed to the behaviour of the majority (Studies 1 and 2). It was only when the behaviour of the previous participants was highly ambiguous that participants behaved as if they had been given no normative information (Study 3). By demonstrating that, except in extreme cases, people use the available information to discern a social norm that influences their behaviour, these findings highlight the power of social norms related to food-related decisions.
Subject(s)
Food Preferences , Snacks , Social Norms , Choice Behavior , Diet , Feeding Behavior , Female , HumansABSTRACT
OBJECTIVE: Overweight and obesity are universal health challenges. Recent evidence emphasises the potential benefits of addressing psychological factors associated with obesity in dietary programmes. This pilot study investigated the efficacy and acceptability of a combined online and face-to-face dietary intervention that used self-compassion, goal-setting and self-monitoring to improve dietary behaviour, as well as psychological factors associated with dietary behaviour. DESIGN: Embedded mixed methods including a 4-week before-after trial and a one-on-one interview. Quantitative outcomes of the study were the levels of self-compassion; eating pathology; depression, anxiety and stress; and dietary intake. Qualitative outcomes were participants' perceptions about the acceptability of the intervention. SETTING: UNSW Kensington campus. PARTICIPANTS: Fourteen participants with overweight and obesity aged between 18 and 55 years old. RESULTS: Results showed that the intervention significantly improved self-compassion and some aspects of dietary intake (e.g. decrease in energy intake) at Week Four compared with Week Zero. Some aspects of eating pathology also significantly decreased (e.g. Eating Concern). However, changes in self-compassion over the 4 weeks did not significantly predict Week Four study outcomes, except for level of stress. Most participants found self-compassion, goal-setting and self-monitoring to be essential for dietary behaviour change. However, participants also indicated that an online programme needed to be efficient, simple and interactive. CONCLUSIONS: In conclusion, the current study provides preliminary but promising findings of an effective and acceptable combined online and face-to-face intervention that used self-compassion, goal-setting and self-monitoring to improve dietary habits. However, the results need to be examined in future long-term randomised controlled trials.
Subject(s)
Diet , Empathy , Goals , Adolescent , Adult , Diet/psychology , Humans , Middle Aged , Obesity , Overweight , Pilot Projects , Young AdultABSTRACT
The Theory of Normal Eating suggests that how much others eat sets an upper limit for how much it is appropriate to eat. This study tested the hypothesis that restrained eaters, who typically eat less than they want to, would be more responsive to a high-intake norm than would unrestrained eaters. Data were combined from 8 experimental studies (total N = 735 female participants; 305 restrained eaters, 430 unrestrained eaters). Each study: (a) included a low-intake norm, a high-intake norm, and a no-norm control condition; (b) measured participants' food intake; and (c) included the Restraint Scale as a measure of dietary restraint. There were no differences between restrained unrestrained eaters in the no-norm control condition or in the magnitude of the inhibition effect (i.e., the difference between the low-intake norm condition and the control condition). There was, however, a restraint difference in the magnitude of the augmentation effect (i.e., the difference between the high-intake norm condition and the control condition). Restrained eaters showed a larger augmentation effect (d = 0.58; 95% CI = 0.29, 0.87) than did unrestrained eaters (d = 0.20; 95% CI = -0.05, 0.45). Social norms provide an upper limit for acceptable food intake, with high-intake norms permitting (but not requiring) individuals to indulge themselves. The fact that restrained eaters were more responsive to the high-intake norm than were unrestrained eaters suggests that the high-intake norm gives restrained eaters permission to indulge when they typically eat less than they want to.
Subject(s)
Diet , Inhibition, Psychological , Eating , Energy Intake , Feeding Behavior , Female , HumansABSTRACT
OBJECTIVE: The current study examined a theoretical model (the identity disruption model) linking negative early life experiences to body dissatisfaction and disordered eating via self-concept clarity and sociocultural factors (internalization of beauty ideals and appearance comparison tendencies). METHOD: 1,023 participants (52% women) completed a series of questionnaires online, including measures of negative early life experiences and childhood abuse, self-concept clarity, internalization of beauty ideals, appearance comparison tendencies, sociocultural pressure to improve one's appearance, body dissatisfaction, and disordered eating. RESULTS: Structural equation modeling indicated that self-reported early adversity was associated with lower self-concept clarity, which in turn was associated with greater internalization of beauty ideals and more frequent appearance comparisons. Internalization and appearance comparisons were associated with body image concerns, which in turn were associated with disordered eating and exercise behaviors. There were few sex differences in these paths. DISCUSSION: These findings provide initial conceptual support for the identity disruption model and extend previous models of body dissatisfaction and disordered eating to include processes that occur earlier in life. This model opens up the possibility for new interventions that are targeted toward those who are most vulnerable to developing body dissatisfaction and disordered eating.
Subject(s)
Body Dysmorphic Disorders/psychology , Body Image/psychology , Feeding and Eating Disorders/psychology , Adolescent , Adult , Female , Humans , Risk , Self Concept , Surveys and Questionnaires , Young AdultABSTRACT
There is accumulating evidence that disgust plays an important role in prejudice toward individuals with obesity, but that research is primarily based on self-reported emotions. In four studies, we examined whether participants displayed a physiological marker of disgust (i.e. levator labii activity recorded using facial electromyography) in response to images of obese individuals, and whether these responses corresponded with their self-reported disgust to those images. All four studies showed the predicted self-reported disgust response toward images of obese individuals. Study 1 further showed that participants exhibited more levator activity to images of obese individuals than to neutral images. However, Studies 2-4 failed to provide any evidence that the targets' body size affected levator responses. These findings suggest that disgust may operate at multiple levels, and that the disgust response to images of obese individuals may be more of a cognitive-conceptual one than a physiological one.
Subject(s)
Attitude to Health , Disgust , Facial Expression , Obesity/psychology , Self Report , Adolescent , Adult , Electromyography/methods , Emotions/physiology , Face/physiology , Female , Humans , Male , Middle Aged , Prejudice , Young AdultABSTRACT
Normative eating cues (portion size, social factors) have a powerful impact on people's food intake, but people often fail to acknowledge the influence of these cues, instead explaining their food intake in terms of internal (hunger) or sensory (taste) cues. This study examined whether the same biases apply when making predictions about how much food a person would eat. Participants (n = 364) read a series of vignettes describing an eating scenario and predicted how much food the target person would eat in each situation. Some scenarios consisted of a single eating cue (hunger, taste, or a normative cue) that would be expected to increase intake (e.g., high hunger) or decrease intake (e.g., a companion who eats very little). Other scenarios combined two cues that were in conflict with one another (e.g., high hunger + a companion who eats very little). In the cue-conflict scenarios involving an inhibitory internal/sensory cue (e.g., low hunger) with an augmenting normative cue (e.g., a companion who eats a lot), participants predicted a low level of food intake, suggesting a bias toward the internal/sensory cue. For scenarios involving an augmenting internal/sensory cue (e.g., high hunger) and an inhibitory normative cue (e.g., a companion who eats very little), participants predicted an intermediate level of food intake, suggesting that they were influenced by both the internal/sensory and normative cue. Overall, predictions about food intake tend to reflect a general bias toward internal/sensory cues, but also include normative cues when those cues are inhibitory. If people are systematically biased toward internal, sensory, and inhibitory cues, then they may underestimate how much food they or other people will eat in many situations, particularly when normative cues promoting eating are present.
Subject(s)
Cues , Eating/psychology , Hunger , Taste , Adolescent , Adult , Aged , Choice Behavior , Female , Food Preferences , Humans , Male , Middle Aged , Portion Size , Social Environment , Young AdultABSTRACT
OBJECTIVES: Unfulfilled basic psychological needs have been associated with disordered eating behaviours, but the mechanisms underlying that associations are not well understood. This study examined a two-stage path model linking basic psychological need satisfaction to disordered eating behaviours via issues of control. METHODS: Female university students (N = 323; Mage = 19.61), community participants (N = 371; Mage = 29.75), and women who self-reported having been diagnosed with an eating disorder (ED; N = 41; Mage = 23.88) completed measures of psychological need satisfaction (i.e., autonomy and competence), issues of control (i.e., feelings of ineffectiveness and fear of losing self-control [FLC]), and ED pathology. RESULTS: Path analysis revealed that unsatisfied needs of autonomy and competence were indirectly related to disordered eating behaviours through feelings of ineffectiveness and FLC. CONCLUSIONS: The results indicate that issues of control might be one of the mechanisms through which lack of psychological need satisfaction is associated with disordered eating. Although the model was constructed using cross-sectional data, these findings suggest potential targets for prevention and treatment efforts aimed at reducing disordered eating in young females. PRACTITIONER POINTS: Our results indicate that young women with chronically unfulfilled basic psychological needs might be vulnerable to developing disordered eating behaviours. The observed patterns suggest that persistent experience of need frustration may engender an internal sense of ineffectiveness and lack of control, which then compels individuals to engage in disordered eating behaviours in an attempt to regain autonomy and competence. Interventions for eating disorders may be most effective when emphasizing the promotion of people's needs for autonomy and competence. Limitations The model was constructed using cross-sectional data. Future experimental and longitudinal studies are needed to confirm the temporal sequence from basic psychological needs to issues of control. The sample only consisted of young women. Further research should explore how thwarting of psychological need satisfaction functions in men. Our clinical sample was small and diagnosis was not confirmed through clinical interview; therefore, those data should be interpreted with caution.
Subject(s)
Emotions/physiology , Feeding and Eating Disorders/psychology , Personal Satisfaction , Self-Control , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , Surveys and Questionnaires , Young AdultABSTRACT
Larger portion sizes have consistently been shown to lead to greater food intake. However, studies of the portion size effect typically provided participants with a single portion of food at a time without any objective information about the size of the portion, and hence failed to consider the potential significance of contextual size information. In order to investigate whether contextual size information moderates the portion size effect, participants were served small or large portions of pasta for lunch in the presence or absence of contextual size information. Study 1 found that the portion size effect on food intake was robust to contextual size information. Study 2 replicated this finding in an online paradigm, showing that contextual size information also had no influence on prospective intake, even when participants chose the portion size they preferred. Both studies also showed that participants' perceptions of how much was appropriate to eat mediated the effect of portion size on intake. A practical implication of our findings is that modifying consumption norms may be an effective way to promote healthier consumer food decisions.
Subject(s)
Choice Behavior , Eating/psychology , Portion Size/psychology , Adolescent , Adult , Attention , Body Mass Index , Caloric Restriction/psychology , Ethnicity/psychology , Female , Food Preferences/psychology , Health Behavior , Humans , Hunger , Internet , Pilot Projects , Prospective Studies , Surveys and Questionnaires , Taste , Young AdultABSTRACT
Weight stigma is a pervasive social problem, and this paper reviews the evidence linking weight stigma to eating behavior. Correlational studies consistently find that experiences with weight stigma are associated with unhealthy eating behaviors and eating pathology (such as binge eating, skipping meals), although results vary somewhat depending on the sample being studied and the specific stigma/eating constructs being assessed. Experimental studies consistently find that manipulations such as priming overweight stereotypes, exposure to stigmatizing content, and social exclusion all lead to increased food intake, but whether or not those manipulations capture the impact of weight stigma experiences per se is less clear. Finally, studies of stigma experiences in daily life show that more frequent stigma experiences are associated with decreased motivation to diet and with less healthy eating behaviors. Overall, this research highlights the potential for weight stigma to negatively impact individuals' eating behavior, which in turn could have consequences for their overall health and well-being.
Subject(s)
Anorexia Nervosa/psychology , Binge-Eating Disorder/psychology , Evidence-Based Medicine , Feeding Behavior/psychology , Overweight/prevention & control , Precision Medicine , Social Stigma , Activities of Daily Living/psychology , Anorexia Nervosa/etiology , Anorexia Nervosa/therapy , Binge-Eating Disorder/etiology , Binge-Eating Disorder/therapy , Body Weight , Combined Modality Therapy/psychology , Diet, Healthy/psychology , Feeding and Eating Disorders/etiology , Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapy , Humans , Nutritional Status , Overweight/psychology , Overweight/therapy , Patient Compliance/psychology , Social Marginalization/psychology , StereotypingABSTRACT
This research examined the effects of both episodic memory and episodic future thinking (EFT) on snack food intake. In Study 1, female participants (n = 158) were asked to recall their lunch from earlier in the day, to think about the dinner they planned to have later in the day, or to think about a non-food activity before taking part in a cookie taste test. Participants who recalled their lunch or who thought about their dinner ate less than did participants who thought about non-food activities. These effects were not explained by group differences in the hedonic value of the food. Study 2 examined whether the suppression effect observed in Study 1 was driven by a general health consciousness. Female participants (n = 74) were asked to think about their past or future exercise (or a non-exercise activity), but thinking about exercise had no impact on participants' cookie consumption. Overall, both thinking about past food intake and imagining future food intake had the same suppression effect on participants' current food intake, but further research is needed to determine the underlying mechanism.
Subject(s)
Eating/psychology , Memory, Episodic , Thinking , Adolescent , Adult , Body Mass Index , Choice Behavior , Energy Intake , Exercise , Female , Humans , Meals , Mental Recall , Snacks , Surveys and Questionnaires , Young AdultABSTRACT
Weight stigma is associated with a range of negative outcomes, including disordered eating, but the psychological mechanisms underlying these associations are not well understood. The present study tested whether the association between weight stigma experiences and disordered eating behaviors (emotional eating, uncontrolled eating, and loss-of-control eating) are mediated by weight bias internalization and psychological distress. Six-hundred and thirty-four undergraduate university students completed an online survey assessing weight stigma, weight bias internalization, psychological distress, disordered eating, along with demographic characteristics (i.e., age, gender, weight status). Statistical analyses found that weight stigma was significantly associated with all measures of disordered eating, and with weight bias internalization and psychological distress. In regression and mediation analyses accounting for age, gender and weight status, weight bias internalization and psychological distress mediated the relationship between weight stigma and disordered eating behavior. Thus, weight bias internalization and psychological distress appear to be important factors underpinning the relationship between weight stigma and disordered eating behaviors, and could be targets for interventions, such as, psychological acceptance and mindfulness therapy, which have been shown to reduce the impact of weight stigma. The evidence for the health consequences resulting from weight stigma is becoming clear. It is important that health and social policy makers are informed of this literature and encouraged develop anti-weight stigma policies for school, work, and medical settings.
Subject(s)
Feeding Behavior/psychology , Feeding and Eating Disorders/etiology , Models, Psychological , Overweight/prevention & control , Self Concept , Social Stigma , Stress, Psychological/etiology , Adolescent , Adult , Body Mass Index , Body Weight Maintenance , Combined Modality Therapy/adverse effects , Combined Modality Therapy/psychology , Cross-Sectional Studies , Emotions , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/psychology , Female , Humans , Internet , Male , Nutrition Surveys , Overweight/physiopathology , Overweight/psychology , Overweight/therapy , Psychiatric Status Rating Scales , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Victoria/epidemiology , Young AdultABSTRACT
PURPOSE: This study examined the causal relationship between attention and memory bias toward thin-body images, and the indirect effect of attending to thin-body images on women's body dissatisfaction via memory. METHOD: In a 2 (restrained vs. unrestrained eaters) × 2 (long vs. short exposure) quasi-experimental design, female participants (n = 90) were shown images of thin models for either 7 s or 150 ms, and then completed a measure of body dissatisfaction and a recognition test to assess their memory for the images. RESULTS: Both restrained and unrestrained eaters in the long exposure condition had better recognition memory for images of thin models than did those in the short exposure condition. Better recognition memory for images of thin models was associated with lower body dissatisfaction. Finally, exposure duration to images of thin models had an indirect effect on body dissatisfaction through recognition memory. CONCLUSIONS: These findings suggest that memory for body-related information may be more critical in influencing women's body image than merely the exposure itself, and that targeting memory bias might enhance the effectiveness of cognitive bias modification programs.
Subject(s)
Body Image/psychology , Diet, Reducing/psychology , Mass Media , Memory/physiology , Personal Satisfaction , Thinness/psychology , Adolescent , Adult , Attention , Body Weight/physiology , Eating/psychology , Emotions/physiology , Female , Humans , Neuropsychological Tests , Photic Stimulation , Young AdultABSTRACT
This paper reviews recent research on consumption stereotypes (judgments of others based on what they eat) and impression management (modifying one's eating behavior in order to create a particular impression). A major recent focus in the literature has been on masculinity and meat eating, with research showing that meat is strongly associated with masculinity, and that individuals who follow a meat-based diet are perceived as more masculine than are individuals who follow a vegetarian diet. Although direct evidence for impression management through food intake remains sparse, a number of methodological approaches (including priming techniques and ecological valid assessments) are described that could be used in future research to identify the motives underlying people's eating behavior. Consumption stereotypes and impression management may be important influences on people's eating behavior, but the complexities of how, when, and for whom these factors influence food intake are still not well understood.
Subject(s)
Feeding Behavior/psychology , Food Preferences/psychology , Research/trends , Social Behavior , Stereotyping , Diet, Vegetarian/psychology , Female , Humans , Judgment , Male , Masculinity , Meat , Sex Factors , VegetablesABSTRACT
OBJECTIVE: Early adverse experiences have been associated with disordered eating, but the mechanisms underlying that association are not well understood. The purpose of this study is to test a structural equation model in which early adversity is associated with disordered eating via intrapersonal resources, interpersonal resources, and body dissatisfaction. METHOD: Female university students (n = 748) completed a series of questionnaires online, including measures of early adverse experiences, intrapersonal resources (self-esteem and personal growth initiative), interpersonal resources (gratitude and social support), body dissatisfaction, and disordered eating and exercising to lose weight. RESULTS: Structural equation modeling indicated that early adverse experiences were negatively associated with interpersonal and intrapersonal resources. Intrapersonal resources were negatively associated with body dissatisfaction, whereas interpersonal resources were positively associated with body dissatisfaction (although negative bivariate correlations in this latter case suggest possible suppression effects). Finally, body dissatisfaction was associated with a range of disordered eating behaviors and exercise. DISCUSSION: Early adverse experiences are important to consider in models of disordered eating. The results of this study highlight potential points of early prevention efforts, such as improving personal resources for those who experience early adversity, to help reduce the risk of body dissatisfaction and disordered eating in young women.
Subject(s)
Body Image , Family Relations , Feeding and Eating Disorders/psychology , Life Change Events , Adolescent , Adult , Exercise , Feeding Behavior , Female , Humans , Male , Models, Psychological , Self Concept , Social Support , Surveys and Questionnaires , Young AdultABSTRACT
We examined the impact of offset controllability (capability of losing weight) and offset effort (efforts to lose weight) on judgments of an obese target. Participants (n = 216) read about an obese person whose body weight was controllable/uncontrollable, and who did/did not put in effort to eat healthily and exercise. Effort played a more important role than controllability in evaluations of the target. Targets who put in effort to be healthy were ascribed fewer obesity stereotypes, evoked less disgust, and were considered to have a more acceptable lifestyle. These findings extend attribution theory and have implications for strategies to reduce weight bias.
Subject(s)
Attitude , Internal-External Control , Motivation , Obesity/psychology , Weight Loss , Adolescent , Adult , Aged , Exercise/psychology , Feeding Behavior/psychology , Female , Humans , Judgment , Life Style , Male , Middle Aged , Social Desirability , Stereotyping , Young AdultABSTRACT
Objective: Adherence to lifestyle changes after bariatric surgery is associated with better health outcomes; however, research suggests that patients struggle to follow post-operative recommendations. This systematic review aimed to examine psychological factors associated with adherence after bariatric surgery. Methods: PubMed, PsycInfo, and Embase were searched (from earliest searchable to August 2022) to identify studies that reported on clinically modifiable psychological factors related to adherence after bariatric surgery. Retrieved abstracts (n = 891) were screened and coded by two raters. Results: A total of 32 studies met the inclusion criteria and were included in the narrative synthesis. Appointment attendance and dietary recommendations were the most frequently studied post-operative instructions. Higher self-efficacy was consistently predictive of better post-operative adherence to diet and physical activity, while pre-operative depressive symptoms were commonly associated with poorer adherence to appointments, diet, and physical activity. Findings were less inconsistent for anxiety and other psychiatric conditions. Conclusions: This systematic review identified that psychological factors such as mood disorders and patients' beliefs/attitudes are associated with adherence to lifestyle changes after bariatric surgery. These factors can be addressed with psychological interventions; therefore, they are important to consider in patient care after bariatric surgery. Future research should further examine psychological predictors of adherence with the aim of informing interventions to support recommended lifestyle changes.