Continual postoperative monitoring of boredom and stress, could help prevent post-surgical loss of control eating

Researchers from the US have reported continual postoperative monitoring of boredom and stress, particularly two to three years after surgery, could help prevent loss of control eating (LOCE) after metabolic and bariatric surgery (MBS), and thus support the long-term psychosocial wellbeing of patients after MBS.

Loss of control eating is defined as the subjective experience of loss of control while eating regardless of the amount of food consumed and has emerged as a salient predictor of negative outcomes following surgery. Particularly, LOCE has been linked to suboptimal post-surgical weight loss and/or weight recurrence and lower quality of life. It is estimated that LOCE occurs in 16.9% to 39% of patients within two years after surgery.

The researchers investigated whether boredom and stress are prospectively associated with LOCE following MBS, and whether these associations change as time progresses following surgery. They hypothesised that (a) higher levels of boredom and stress in the moment would prospectively predict more severe LOCE between one- and three-years following MBS and (b) that the strength of these associations would increase as a greater amount of time elapsed during this period.

Outcomes

In total, 150 participants (female 87%, n=124 and White 78.3%, n=112) who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) MBS procedures were included in the study, with 143 participants contributing data in year one, 110 in year two and 91 in year three. Approximately fifty five percent (n=80) of the sample reported LOCE at one-year post-surgery, 51.8% (n=57) at two-years post-surgery and 42.9% (n=42) at three-years post-surgery.

Post-hoc analyses revealed that higher momentary boredom was associated with more severe subsequent LOCE at year 2 (p<0.001), but was not associated with LOCE severity at year one (p=0.639) or year three (p=0.689). There were also significant interactions between boredom and year at the between-person level; higher overall boredom was associated with more severe LOCE during the EMA protocol at year 2 (p=0.018) and year three (p=0.001), but it was not associated with LOC eating at year one (p=0.073). Additionally, the strength of the between-person relation between boredom and LOCE increased from year two to year three.

The study authors reported significant within-person and between-person main effects of stress on LOCE, when controlling for year since surgery. At the within-person level, higher momentary stress (relative to one’s own average) was associated with more severe subsequent LOCE. At the between-person level, higher overall stress (relative to the sample average) was associated with more severe LOCE during the EMA protocol.

Regarding variability in these associations over time, a significant interaction emerged between stress and year post-MBS at the within-person level. Post-hoc analyses revealed that higher momentary stress was associated with more severe subsequent LOCE at year two (p=0.005), but was not associated with LOCE at year one (p=0.467). The within-person association between stress and LOCE was similar at year two compared to year three. There were also significant interactions between stress and year post-MBS at the between-person level; higher overall stress was associated with a greater severity of LOCE during the EMA protocol at year one (p=0.023), year two (p<0.001) and year three (p=0.006), but this association was strongest at year two.

“This study provides novel insights into the associations among boredom, stress and LOCE following MBS. The ability to manage negative emotions is linked to health-related quality of life outcomes,” the authors concluded. “Our findings suggest continual postoperative monitoring of boredom and stress (especially 2-3 years following surgery) and intervention could help prevent LOCE after MBS and thus support the long-term psychosocial wellbeing of patients after MBS.”

The findings were reported in the paper, ‘Boredom and Stress as Momentary Predictors of Loss of Control Eating after Metabolic and Bariatric Surgery: A Longitudinal Investigation’, published in SOARD. To access this paper, please click here