title: Weight bias internalization, emotion dysregulation, and non-normative eating behaviors in prebariatric patients.
abstract: OBJECTIVE
  Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation.
  
  
  METHODS
  Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling.
  
  
  RESULTS
  The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms.
  
  
  CONCLUSIONS
  Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.
authors.affiliation: Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Baldofski
authors.affiliation: Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
authors.forename: Almut
authors.initials: A
authors.lastname: Rudolph
authors.affiliation: Department of General Surgery, Asklepios Clinic, Hamburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tigges
authors.affiliation: Schön Klinik Hamburg Eilbek Bariatric Clinic, Hamburg, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Herbig
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jurowich
authors.affiliation: Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Konstanz, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kaiser
authors.affiliation: Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Dietrich
authors.affiliation: Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Hilbert
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology*; D016739:Behavior, Addictive; D001828:Body Image / Q000523:psychology; D001835:Body Weight; D003674:Defense Mechanisms; D004644:Emotions; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery; D057234:Preoperative Period; D057566:Self Report; D055815:Young Adult
keywords: bariatric surgery; eating disorder psychopathology; emotion regulation; non-normative eating behavior; weight bias internalization