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Impulsivity, Negative Mood, and Disordered Eating in Obesity
Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.ORCID-id: 0000-0003-4570-5891
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Bariatric surgery is a life-altering procedure that leads to substantial weight loss for most patients with obesity. Psychiatric conditions that may interfere with eating behavior and other behavioral prescriptions after surgery are common. Disordered eating is an established risk factor for inferior weight loss but the effects of negative mood and impulsivity are largely unknown. This thesis aims to investigate the prevalence of and associations between these potential risk factors and eating behavior in bariatric surgery patients.

Study I assessed the prevalence of adult Attention Deficits/Hyperactivity Disorder (ADHD) symptoms in bariatric surgery patients. Symptoms of adult ADHD were elevated compared to the normal population and associated with symptoms of disordered eating, anxiety, and depression.

Study II investigated whether treatment with Behavioral Activation (BA) could ameliorate binge eating and other symptoms of disordered eating in patients with obesity and Binge Eating Disorder. The results showed that BA was effective in increasing activity levels and improving mood but not in ameliorating binge eating in these patients.

Study III was a prospective study on disordered eating, symptoms of depression and anxiety, symptoms of adult ADHD, and alcohol risk consumption before surgery and at follow-up after 12 months. After controlling for age, no variable measured before surgery could predict weight loss after surgery. Disordered eating after surgery was associated with inferior weight loss in men and a subgroup of older female participants.

The present thesis concludes that symptoms of adult ADHD are common among bariatric surgery patients and associated with disordered eating. There is no indication that symptoms of adult ADHD are associated with short-term inferior weight loss after surgery. However, adult ADHD may be a risk factor for postsurgical alcohol abuse. The treatment study showed no direct association among activity, mood, and binge eating. BA, while effective in improving mood, was found not to be an effective treatment for BED, at least in the short group format investigated.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2014. , s. 78
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 100
Nyckelord [en]
Obesity, Eating disorder, Depression, ADHD
Nationell ämneskategori
Psykologi
Forskningsämne
Psykologi
Identifikatorer
URN: urn:nbn:se:uu:diva-226380ISBN: 978-91-554-8993-9 (tryckt)OAI: oai:DiVA.org:uu-226380DiVA, id: diva2:736542
Disputation
2014-09-26, Betty Pettersson-salen, Blåsenhus, von Kraemers allé 1A, Uppsala, 10:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2014-09-04 Skapad: 2014-06-16 Senast uppdaterad: 2018-05-08
Delarbeten
1. Screening of Adult ADHD Among Patients Presenting for Bariatric Surgery
Öppna denna publikation i ny flik eller fönster >>Screening of Adult ADHD Among Patients Presenting for Bariatric Surgery
2012 (Engelska)Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 22, nr 6, s. 918-926Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In the field of bariatric surgery, research on symptoms of adult attention deficit hyperactivity disorder (ADHD) and their interrelationships with other psychological risk factors such as depression and anxiety is scarce. The symptoms of adult ADHD seem to be common in the obese population, but they are rarely investigated before bariatric surgery. ADHD-related symptoms such as impulsivity have at the same time been identified as potential risk factors for less successful weight loss among bariatric surgery patients. The aims of the current study were to screen for symptoms of adult ADHD and to investigate their relationships with other psychological risk factors. Candidates for bariatric surgery ( = 187) were anonymously screened for symptoms of anxiety, depression, and adult ADHD, in addition to disordered eating patterns, by means of questionnaires. The relations between these symptoms were investigated. In the current sample, 10% of patients screened positively for adult ADHD, and the symptoms of adult ADHD were significantly correlated with those of anxiety, depression, and disordered eating. The results show that adult ADHD is more common in this clinical group than in the general population (4%) and that adult ADHD is associated with disordered eating patterns, depression, and anxiety. Further prospective research, using multivariate analysis, is needed to investigate whether the symptoms of adult ADHD, and their interaction with anxiety, depression, or disordered eating, may possibly constitute a risk factor in terms of difficulties in adhering to the post-surgery regime and its potential unfavorable outcome.

Nyckelord
Bariatric surgery, Adult ADHD, Anonymous screening, Disordered eating, Binge eating disorder
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-175606 (URN)10.1007/s11695-011-0569-9 (DOI)000304117100013 ()
Tillgänglig från: 2012-06-12 Skapad: 2012-06-11 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
2. Group Behavioral activation for patients with severe obesity and Binge eating disorder: A randomized controlled trial
Öppna denna publikation i ny flik eller fönster >>Group Behavioral activation for patients with severe obesity and Binge eating disorder: A randomized controlled trial
2015 (Engelska)Ingår i: Behavior modification, ISSN 0145-4455, E-ISSN 1552-4167, Vol. 39, nr 2, s. 270-294Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa.

Nationell ämneskategori
Psykologi
Forskningsämne
Psykologi
Identifikatorer
urn:nbn:se:uu:diva-226371 (URN)10.1177/0145445514553093 (DOI)000349992100002 ()25268019 (PubMedID)
Tillgänglig från: 2014-06-16 Skapad: 2014-06-16 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
3. Is age a better predictor of weight loss one year after Gastric bypass than symptoms of disordered eating, depression, adult ADHD, and alcohol consumption?
Öppna denna publikation i ny flik eller fönster >>Is age a better predictor of weight loss one year after Gastric bypass than symptoms of disordered eating, depression, adult ADHD, and alcohol consumption?
2014 (Engelska)Ingår i: Eating Behaviors, ISSN 1471-0153, E-ISSN 1873-7358, Vol. 15, nr 4, s. 644-647Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

INTRODUCTION:

Findings regarding psychological risk factors for low weight loss after bariatric surgery have been inconsistent. The association between gender and weight outcome is unclear while younger age has been consistently shown to be associated with better weight outcome. The aim of this study was to analyze the interactions between gender and age on the one hand and symptoms of disordered eating, depression, adult ADHD and alcohol consumption on the other hand in regard to weight loss after gastric bypass.

METHODS:

Bariatric surgery patients were recruited and asked to fill out self-report questionnaires regarding behavioral risk factors before and twelve months after surgery. Data from one hundred and twenty-nine patients were analyzed.

RESULTS:

After controlling for age, no psychological variable measured prior to surgery could predict weight loss after twelve months. After surgery, there was an interaction effect between age, gender and specific eating disorder symptoms. Specifically, loss of control over eating was a risk factor for low weight loss among older, but not among younger, female participants. Symptoms of adult ADHD were associated with elevated alcohol consumption after surgery.

DISCUSSION:

These results indicate that age and gender may moderate the effects of potential risk factors for inferior weight outcome. This interaction could potentially be one of the reasons behind the mixed findings in this field. Thus, there are important gender differences in the bariatric population that should be considered. The present study is the first to show that symptoms of adult ADHD may not be a risk factor for inferior weight loss but for alcohol risk consumption after gastric bypass.

Nationell ämneskategori
Psykologi Psykiatri
Identifikatorer
urn:nbn:se:uu:diva-226377 (URN)10.1016/j.eatbeh.2014.08.024 (DOI)000345402700025 ()25260133 (PubMedID)
Tillgänglig från: 2014-06-16 Skapad: 2014-06-16 Senast uppdaterad: 2018-05-08Bibliografiskt granskad

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