The Interaction Between Mindfulness, Emotion Regulation, and Social Anxiety and Its Association with Emotional Eating in Bariatric Surgery Candidates

Previous research has shown that emotional eating is common in bariatric surgery candidates, and may be related to poorer surgical outcomes. Emotional eating may be particularly common in surgery candidates reporting social anxiety symptoms, but less is known about the possible mechanisms that may link social anxiety and emotional eating. The aim of the current study was to examine the interaction between mindfulness/emotion regulation and social anxiety and the association of this interaction with emotional eating in bariatric surgery candidates. Bariatric surgery candidates (n = 1088) were referred by their surgeons for a comprehensive psychiatric presurgical evaluation, including a semistructured diagnostic interview and self-report questionnaires. The relationship between emotional eating and the interaction of mindfulness facets/emotion regulation skills and social anxiety was examined using hierarchical linear regressions. The interaction between social anxiety and the mindfulness facets of observing, describing, and acting with awareness was significantly associated with emotional eating after controlling for covariates. However, only the observing by social anxiety interaction was significant relative to the other facets in a final regression model. The interaction between social anxiety and emotional regulation deficits related to goals, strategies, impulse control, and clarity was significantly associated with emotional eating, but only the nonacceptance by social anxiety interaction was significant relative to the other emotion regulation subscales. Findings continue to suggest a potential link between social anxiety and emotional eating in bariatric surgery candidates, and indicate that deficits in certain mindfulness facets and emotion regulation skills may be particularly relevant in this sample.