- •Data were a good-to-excellent fit for the original EEI model
- •All EEI factors were correlated with baseline eating disorder symptoms
- •Greater negative reinforcement expectancies predicted poorer weight loss
While presurgical eating behaviors have demonstrated limited prognostic value, cognitions regarding the effects of eating may serve as important predictors of weight loss outcomes after bariatric surgery. The Eating Expectancies Inventory (EEI) is a commonly used, self-report measure of expected consequences of eating; however, its psychometric and predictive properties have not yet been evaluated among bariatric surgery patients.
This study sought to examine the factor structure and internal consistency of the EEI among bariatric surgery candidates, to examine relationships between EEI factors and measures of eating psychopathology, and to explore the effects of eating expectancies on postsurgical weight loss.
Data originated from an interdisciplinary bariatric surgery center in the Midwest United States.
Two hundred sixty-two women completed self-report questionnaires before bariatric surgery. Presurgical data and available postsurgical weights (at 6, 12, and 18 mo) were obtained from medical records.
Analyses indicated that the original 5-factor model was a good-to-excellent fit for the EEI data. All EEI factors demonstrated good reliability and were significantly associated with eating disorder symptoms and behaviors at baseline. Higher scores on EEI Factor 1 (negative affect) and Factor 5 (alleviates boredom) predicted poorer weight loss at 18 months postsurgery (n = 132).
Findings support the reliability and validity of the EEI among female bariatric candidates. Presurgical eating expectancies were linked to pathologic eating patterns and also predicted postsurgical weight loss trajectories, suggesting that eating expectancies may have prognostic value as predictors of bariatric surgery outcomes.
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- Weight recidivism post-bariatric surgery: a systematic review.Obes Surg. 2013; 23: 1922-1933
- Eating pathology and associations with long-term changes in weight and quality of life in the longitudinal assessment of bariatric surgery study.Int J Eat Disord. 2018; 51: 1322-1330
- Binge Eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery.Eur Eat Disord Rev. 2014; 22: 87-91
- Stability of problematic eating behaviors and weight loss trajectories after bariatric surgery: a longitudinal observational study.Surg Obes Relat Dis. 2017; 13: 1063-1070
- Psychological predictors of weight loss after bariatric surgery: a review of the recent research.Obes Res Clin Pract. 2014; 8: e299-e313
- Preoperative predictors of weight loss following bariatric surgery: systematic review.Obes Surg. 2012; 22: 70-89
- An application of expectancy theory to eating disorders: development and validation of measures of eating and dieting expectancies.Psychol Assess. 1998; 10: 49-58
- Applications of a social learning theory of personality.Holt, Rinehart & Winston, Oxford, UK1972
- Purposive behavior in animals and men.Appleton-Century, Oxford1932
- Introduction and overview.in: Sher K.J. Oxford handbook of substance use substance use disorder. Oxford University Press, New York2016: 1-25
- The role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibition.Eat Behav. 2016; 21: 129-134
- Thinness and eating expectancies predict subsequent binge-eating and purging behavior among adolescent girls.J Abnorm Psychol. 2007; 116: 188-197
- Internal disinhibition predicts weight regain following weight loss and weight loss maintenance.Obesity. 2007; 15: 2485-2494
- Implications of emotional eating beliefs and reactance to dietary advice for the treatment of emotional eating and outcome following Roux-en-Y gastric bypass.Clin Case Stud. 2009; 8: 277-295
- Psychosocial predictors of weight loss and psychological adjustment following bariatric surgery and a weight-loss program: the mediating role of emotional eating.Int J Eat Disord. 2009; 42: 109-117
- Surgically induced changes in gut microbiome and hedonic eating as related to weight loss: preliminary findings in obese women undergoing bariatric surgery.Psychosom Med. 2017; 79: 880-887
- Validation of eating and dieting expectancy measures in two adolescent samples.Int J Eat Disord. 2002; 31: 461-473
- Coping with distress by eating or drinking: role of trait urgency and expectancies.Psychol Addict Behav. 2004; 18: 269-274
- A risk model for preadolescent disordered eating.Int J Eat Disord. 2011; 44: 596-604
- Maintenance factors for persistence of bulimic pathology: a prospective natural history study.Int J Eat Disord. 2009; 42: 173-178
- Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder.Psychol Assess. 2000; 12: 123-131
- Maladaptive eating behavior assessment among bariatric surgery candidates: evaluation of the Eating Disorder Diagnostic Scale.Surg Obes Relat Dis. 2017; 13: 1183-1188
- The assessment of binge eating severity among obese persons.Addict Behav. 1982; 7: 47-55
- Obese binge eaters: affect, cognitions, and response to behavioural weight control.J Consult Clin Psychol. 1988; 56: 433-439
- Examining the Binge Eating Scale in screening for binge eating disorder in bariatric surgery candidates.Obes Surg. 2013; 23: 1-6
- Confirmatory factor analysis for applied research.The Guilford Press, New York2006
- Twelve frequently asked questions about growth curve modeling.J Cogn Dev. 2010; 11: 121-136
- Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives.Struct Equ Model A Multidiscip J. 1999; 6: 1-55
- Alternative ways of assessing model fit.in: Bollen K.A. Long J.S. Testing structural equation models. Sage, Newbury Park, CA1993: 136-462
- Structural equation modeling with lisrel, prelis, and simplis.Routledge, Abingdon, UK1998
- Negative affect prior to and following overeating-only, loss of control eating-only, and binge eating episodes in obese adults.Int J Eat Disord. 2015; 48: 641-653
- Neurobehavioral inhibition of reward-driven feeding: implications for dieting and obesity.Obesity. 2009; 17: 640-647
- Relation of reward from food intake and anticipated food intake to obesity: a functional magnetic resonance imaging study.J Abnorm Psychol. 2008; 117: 924-935
- Brief, four-session group CBT reduces binge eating behaviors among bariatric surgery candidates.Surg Obes Relat Dis. 2009; 5: 257-262
- A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery phohatients.Cogn Behav Pract. 2008; 15: 364-375
Published online: August 12, 2019
Accepted: July 31, 2019
Received: April 23, 2019
This research was supported by Kent State University Community Research Fellowship Award (awarded to MAWH) and in part by the National Institutes of Mental Health (T32 MH08276).
© 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.