Background:

One in four Canadians suffer from obesity.  Bariatric surgery is the most effective method to achieve substantial and enduring weight loss.  However, one in five individuals who receive bariatric surgery do not lose a significant amount of weight.  Further, one in four individuals regain a significant portion of lost weight within 5-10 years of receiving surgery.

Description of Research Initiative:

This is a joint collaboration with the Newfoundland and Labrador provincial Bariatric Surgery program. We are interested in identifying psychological (i.e., motivation, mood, self-esteem) and social characteristics (i.e. social support) that predict weight-loss and quality of life outcomes following bariatric surgery. Identifying characteristics that predict successful weight loss and improvements in quality of life can help healthcare providers and individuals seeking surgery make informed decisions about the benefits and risks of receiving bariatric surgery.  Moreover, such information can inform interventions aimed at improving long-term outcomes for individuals who undergo surgery. Finally, we are interested in evaluating how psychological and social characteristics change between pre- and post-surgery.

Data was being collected in Alberta in collaboration with our colleagues at the Calgary Adult Bariatric Specialty Clinic.

Results

This program of research has enhanced our understanding of factors that influence outcomes following bariatric surgery and led to the development and evaluation of a novel intervention to improve outcomes. Specifically, this research:

1. Identified an association between higher symptoms of attention deficit hyperactivity disorder and less weight loss 12-months following bariatric surgery, particularly among individuals who had difficulty with emotion regulation:
   • Williamson, T. M., Campbell, T. S., Telfer, J. A., & Rash, J. A. (2018). Emotion self-regulation moderates the association between symptoms of ADHD and weight loss after bariatric surgery. Obesity surgery, 28, 1553-1561.
2. Revealed that weight-related self-esteem, and concerns over shape and weight improve within 12-months following bariatric surgery with greater improvement associated with greater weight-loss.
   • Felske, A. N., Williamson, T. M., Scurrey, S. R., Telfer, J. A., Campbell, T. S., & Rash, J. A. (2021). The influence of weight-related self-esteem and symptoms of depression on shape and weight concerns and weight-loss 12 months after bariatric surgery. Obesity surgery, 31, 1062-1072.
3. Informed ethical considerations for the pre-surgical psychosocial assessment of bariatric surgery candidates.
   • Rouleau, C. R., Rash, J. A., & Mothersill, K. J. (2016). Ethical issues in the psychosocial assessment of bariatric surgery candidates. Journal of health psychology, 21(7), 1457-1471.
   • Williamson, T. M., Rash, J. A., Campbell, T. S., & Mothersill, K. (2020). Ethical considerations in assessment and behavioral treatment of obesity: Issues and practice implications for clinical health psychologists. Professional Psychology: Research and Practice, 51(2), 95.
4. Led to the development and proof-of-concept evaluation of a mindfulness-informed intervention for eating disorder symptoms, self-efficacy and emotion regulation among bariatric surgery candidates.
   • Felske, A. N., Williamson, T. M., Rash, J. A., Telfer, J. A., Toivonen, K. I., & Campbell, T. (2022). Proof of concept for a mindfulness-informed intervention for eating disorder symptoms, self-efficacy, and emotion regulation among bariatric surgery candidates. Behavioral Medicine, 48(3), 216-229.