Elsevier

Eating Behaviors

Volume 18, August 2015, Pages 36-40
Eating Behaviors

Attachment style and emotional eating in bariatric surgery candidates: The mediating role of difficulties in emotion regulation

https://doi.org/10.1016/j.eatbeh.2015.03.011Get rights and content

Highlights

  • •

    Obese individuals have been found to engage in emotional eating

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    We examined emotion regulation difficulties in a bariatric surgery patient population

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    We found emotion regulation difficulties to be a potential mechanism through which attachment insecurity may affect emotional eating

Abstract

Objective

Difficulties with emotion regulation is a hypothesized mechanism through which attachment insecurity may affect emotional eating. No studies have yet investigated this effect in the bariatric population. Because many obese individuals engage in emotional eating, difficulty regulating emotion may be an important underlying mechanism through which attachment insecurity is linked to emotional eating in bariatric surgery candidates.

Methods

In this cross-sectional study, 1393 adult bariatric surgery candidates from the Toronto Western Hospital were recruited to complete the Emotional Eating Scale (EES), Patient Health Questionnaire-9 (PHQ9), Generalized Anxiety Disorder-7 (GAD7), Difficulties in Emotion Regulation Scale (DERS), Eating Disorder Examination Questionnaire (EDE-Q), and the Experiences for Close Relationships 16-item Scale (ECR-16) in order to explore the mediating role of emotion regulation on the relationship between attachment insecurity and emotional eating. Path analysis within a structural equation modeling framework examined direct and indirect effects of attachment insecurity on emotional eating.

Results

The indices of this overall model indicated that the specified set of direct and indirect pathways and corresponding correlations were a good fit with the data (RMSEA < .06, CFI = 1.00; SRMR < .08). Moreover, tests of all of the possible indirect pathways between attachment style and emotional eating were significant.

Discussion

Findings suggest that difficulties in emotion regulation may be an important mechanism to consider when examining the association between attachment insecurity and emotional eating in adult bariatric surgery candidates. Although causality cannot be concluded, these results shed light on the important role that emotion regulation may have in predicting problematic eating in bariatric patients.

Section snippets

Participants

Participants included 2120 consecutively referred candidates who were assessed by the Toronto Western Hospital Bariatric Surgery program (TWH-BSP), a Level 1A bariatric surgery Centre of Excellence accredited by the American College of Surgeons and one of two adult bariatric surgery assessment centers within the University of Toronto Bariatric Surgery Collaborative.

Procedure

Patients were referred to the TWH-BSP through a centralized provincial bariatric surgery registry called the Ontario Bariatric

Descriptive data and correlations

Two hundred and eighty-eight males and 1095 females (mean age 44.72 years, mean BMI = 49.05 kg/m2) undergoing assessment for bariatric surgery completed at least one of the current study's psychosocial measures and were included in the current study. Although no significant differences in age or BMI were found between patients included in the current analyses and patients excluded (n = 737) due to lack of completion of any of the study measures, significant differences in gender were found between

Discussion

The current study examined pathways that link insecure attachment to emotional eating in individuals being assessed for bariatric surgery. Cross-sectional path analyses revealed that difficulties in emotion regulation were an important underlying mechanism linking insecure attachment styles to emotional eating, even when statistically accounting for the influence of concurrent anxiety, depression, and global disordered eating in bariatric surgery candidates.

Overall results suggest that

Role of funding sources

There is no funding source for this study.

Contributors

Marlene Taube-Schiff and Jessica Van Exan co-authored the manuscript and in doing so summarized the literature related to this manuscript and contributed substantially to the interpretation this work.

Rika Tanaka performed the data analyses for the study and wrote the results section of the manuscript.

Susan Wnuk has contributed to the conceptualization of measures used in the study and was involved in the analyses of the data.

Raed Hawa has provided contributions to the conceptualization of this

Conflict of interest

There are no conflicts of interest for any of the authors to declare.

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