The impact of weight loss surgery on disordered eating and body image

Abstract

The first part of this thesis is a review of the literature investigating the impact of targeted psychological interventions on disordered eating and the subsequent impact on weight loss in individuals who have undergone weight loss surgery. Twelve studies were selected for inclusion within the review and their methodological quality was assessed. The findings were contradictory. Although some studies suggested that targeted psychological interventions can ameliorate disordered eating behaviours and support weight loss post-operatively, others reported no improvements. The discussion highlights a number of methodological limitations and consequently, the results must be interpreted with caution. This body of literature is in its infancy and as such, it is crucial that future research focuses on the rigorous evaluation of such interventions in order to inform clinically responsive and effective services.

The empirical part of this thesis explored the psychological characteristics of a postweight loss surgery population. The research also explored the predictors of body image dissatisfaction and disordered eating behaviour, including the extent to which self-ideal discrepancies were predictive of these variables. The study also explored the impact of a brief self-compassion letter writing intervention on levels of self-compassion and affect. The overall pattern of results highlighted the presence of elevated levels of psychological distress, body image dissatisfaction and disordered eating behaviour and low levels of self-esteem in the weight loss surgery population. Participants held unrealistic weight loss expectations following surgery and substantial discrepancies existed between individuals’ current and ideal body shapes, which were predictive of body image dissatisfaction and disordered eating behaviour. Trait self-esteem and shape concern significantly predicted body image dissatisfaction, whereas weight phobia and negative affect predicted disordered eating behaviour. Engagement in the brief self-compassion letter writing task led to improvements in both affect and selfcompassion. Clinical implications, limitations of the current study and directions for future research directions are considered within the discussion.

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