title: Binge eating in bariatric surgery candidates: The role of insecure attachment and emotion regulation.
abstract: Binge eating has a high prevalence among bariatric patients and is associated with post-surgical weight gain. This study examined the potential mediating role of emotion regulation difficulties in the relation between attachment insecurity and binge eating among this population. Participants were 1388 adult pre-bariatric surgery candidates from an accredited bariatric surgery assessment centre in Toronto, Ontario. Participants completed measures of psychological functioning, including attachment style and emotion regulation. Mediation analyses revealed that difficulties with emotion regulation mediated a positive association between insecure-anxious attachment and binge eating. An insecure-avoidant attachment was found to have a non-significant association with binge eating when examining the total effect. However, when difficulties with emotion regulation were controlled for in the model to examine its role as a mediator, this association became significant, and emotion regulation difficulties also mediated the relationship between attachment avoidance and binge eating. These findings suggest that difficulties in emotion regulation may be an important clinical issue to address in order to reduce binge eating in adult bariatric surgery candidates.
authors.affiliation: Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada.
authors.forename: Sharry
authors.initials: S
authors.lastname: Shakory
authors.affiliation: Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada. Electronic address: jessica.vanexan@uhn.ca.
authors.forename: Jessica
authors.initials: J
authors.lastname: Van Exan
authors.affiliation: Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Mills
authors.affiliation: Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sockalingam
authors.affiliation: Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada.
authors.forename: Leah
authors.initials: L
authors.lastname: Keating
authors.affiliation: Psychosocial Bariatric Surgery Program, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON, M5T 1R8, Canada.
authors.forename: Marlene
authors.initials: M
authors.lastname: Taube-Schiff
mesh_terms: D000275:Adjustment Disorders / Q000517:prevention & control* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000517:prevention & control* / Q000523:psychology; D050110:Bariatric Surgery / Q000523:psychology*; D056912:Binge-Eating Disorder / Q000517:prevention & control* / Q000523:psychology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D000066498:Emotional Adjustment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009767:Obesity, Morbid / Q000517:prevention & control / Q000523:psychology / Q000601:surgery; D009769:Object Attachment; D009864:Ontario; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology; D012008:Recurrence; D012944:Social Support; D055815:Young Adult
keywords: Bariatric surgery; Binge eating; Emotion regulation; Insecure attachment