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Erschienen in: Obesity Surgery 6/2018

24.11.2017 | Original Contributions

Emotion Self-Regulation Moderates the Association Between Symptoms of ADHD and Weight Loss After Bariatric Surgery

verfasst von: Tamara M. Williamson, Tavis S. Campbell, Jo Ann Telfer, Joshua A. Rash

Erschienen in: Obesity Surgery | Ausgabe 6/2018

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Abstract

Background

This study aimed to examine the combined effect of pre-surgical emotion self-regulation (ESR) and symptoms of attention deficit hyperactivity disorder (sADHD, i.e., inattention, impulsivity, and hyperactivity) on weight loss 12 months following bariatric surgery independent of psychological distress and eating pathology.

Methods

Adults with obesity were recruited from a bariatric surgery specialty clinic in Canada. Patients completed measures of psychological distress (i.e., Beck Depression Inventory II and Beck Anxiety Inventory), eating pathology (i.e., Eating Disorder Examination Questionnaire), ESR (i.e., “Managing Own Emotions” subscale of the Schutte Emotional Intelligence Test), and sADHD (i.e., Adult ADHD Self-Report Scale) prior to surgery. Measures of height and weight were obtained and used to calculate percent excess weight loss (%EWL) of body mass index (BMI) pre- and 12 months post-surgery.

Results

Thirty-seven patients were recruited. The final sample consisted of 30 patients (80% female; mean age = 48 years; mean BMI = 49.32). Patients experienced significant weight loss and reported significant improvement in anxiety, depressed mood, and eating pathology from pre- to 12 months post-surgery. A significant sADHD by ESR interaction on %EWL (F(1, 21) = 6.43, p = .019) was observed and accounted for 13% of unique variance after adjusting for relevant covariates. Probing the interaction with the Johnson-Neyman technique indicated that there was a significant inverse association between sADHD and %EWL among individuals who scored ≤ 0.15 SD below the mean on ESR.

Conclusions

ESR moderated the association between sADHD and %EWL, suggesting that sADHD may attenuate weight loss following bariatric surgery among individuals deficient in ESR. This finding has implications for bariatric surgery pre-surgical psychological assessment.
Literatur
1.
Zurück zum Zitat Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017;376(7):641–51. Epub 2017/02/16. doi: https://doi.org/10.1056/NEJMoa1600869. PubMed PMID: 28199805; PubMed Central PMCID: PMCPMC5451258. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes—5-year outcomes. N Engl J Med. 2017;376(7):641–51. Epub 2017/02/16. doi: https://​doi.​org/​10.​1056/​NEJMoa1600869. PubMed PMID: 28199805; PubMed Central PMCID: PMCPMC5451258.
2.
Zurück zum Zitat Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386(9997):964–973. Epub 2015/09/16. doi: https://doi.org/10.1016/S0140-6736(15)00075-6. PubMed Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386(9997):964–973. Epub 2015/09/16. doi: https://​doi.​org/​10.​1016/​S0140-6736(15)00075-6. PubMed
3.
Zurück zum Zitat Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149(3):275–87. Epub 2013/12/20. doi: https://doi.org/10.1001/jamasurg.2013.3654. PubMed PMID: 24352617; PubMed Central PMCID: PMCPMC3962512. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149(3):275–87. Epub 2013/12/20. doi: https://​doi.​org/​10.​1001/​jamasurg.​2013.​3654. PubMed PMID: 24352617; PubMed Central PMCID: PMCPMC3962512.
8.
Zurück zum Zitat Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56. e5. Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56. e5.
9.
Zurück zum Zitat O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg 2013;257(1):87–94. Epub 2012/12/14. doi: https://doi.org/10.1097/SLA.0b013e31827b6c02. PubMed O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg 2013;257(1):87–94. Epub 2012/12/14. doi: https://​doi.​org/​10.​1097/​SLA.​0b013e31827b6c02​. PubMed
13.
16.
Zurück zum Zitat Spitznagel MB, Alosco M, Strain G, Devlin M, Cohen R, Paul R, et al. Cognitive function predicts 24-month weight loss success after bariatric surgery. Surg Obes Relat Dis. 2013;9(5):765–70. Epub 2013/07/03. doi: https://doi.org/10.1016/j.soard.2013.04.011. PubMed PMID: 23816443; PubMed Central PMCID: PMCPMC3788845. Spitznagel MB, Alosco M, Strain G, Devlin M, Cohen R, Paul R, et al. Cognitive function predicts 24-month weight loss success after bariatric surgery. Surg Obes Relat Dis. 2013;9(5):765–70. Epub 2013/07/03. doi: https://​doi.​org/​10.​1016/​j.​soard.​2013.​04.​011. PubMed PMID: 23816443; PubMed Central PMCID: PMCPMC3788845.
17.
18.
Zurück zum Zitat Nicolau J, Ayala L, Frances C, Sanchis P, Zubillaga I, Pascual S, et al. Are subjects with criteria for adult attention-deficit/hyperactivity disorder doing worse after bariatric surgery? A case-control study. Nutr Hosp 2014;31(3):1052–1058. Epub 2014/01/01. doi: https://doi.org/10.3305/nh.2015.31.3.8089. PubMed Nicolau J, Ayala L, Frances C, Sanchis P, Zubillaga I, Pascual S, et al. Are subjects with criteria for adult attention-deficit/hyperactivity disorder doing worse after bariatric surgery? A case-control study. Nutr Hosp 2014;31(3):1052–1058. Epub 2014/01/01. doi: https://​doi.​org/​10.​3305/​nh.​2015.​31.​3.​8089. PubMed
21.
Zurück zum Zitat Levy LD, Fleming JP, Klar D. Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder. Int J Obes 2009;33(3):326–334. Epub 2009/02/19. doi: https://doi.org/10.1038/ijo.2009.5. PubMed Levy LD, Fleming JP, Klar D. Treatment of refractory obesity in severely obese adults following management of newly diagnosed attention deficit hyperactivity disorder. Int J Obes 2009;33(3):326–334. Epub 2009/02/19. doi: https://​doi.​org/​10.​1038/​ijo.​2009.​5. PubMed
25.
Zurück zum Zitat Spitznagel MB, Galioto R, Limbach K, Gunstad J, Heinberg L. Cognitive function is linked to adherence to bariatric postoperative guidelines. Surg Obes Relat Dis. 2013;9(4):580–5. Epub 2013/06/25. doi: https://doi.org/10.1016/j.soard.2013.04.007. PubMed PMID: 23791534; PubMed Central PMCID: PMCPMC3737380. Spitznagel MB, Galioto R, Limbach K, Gunstad J, Heinberg L. Cognitive function is linked to adherence to bariatric postoperative guidelines. Surg Obes Relat Dis. 2013;9(4):580–5. Epub 2013/06/25. doi: https://​doi.​org/​10.​1016/​j.​soard.​2013.​04.​007. PubMed PMID: 23791534; PubMed Central PMCID: PMCPMC3737380.
26.
Zurück zum Zitat Barkley R. Deficient emotional self-regulation: a core component of attention-deficit/hyperactivity disorder. J ADHD Relat Disord. 2010;1(2):5–37. Barkley R. Deficient emotional self-regulation: a core component of attention-deficit/hyperactivity disorder. J ADHD Relat Disord. 2010;1(2):5–37.
29.
30.
Zurück zum Zitat Surman CB, Biederman J, Spencer T, Miller CA, McDermott KM, Faraone SV. Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study. Atten Defic Hyperact Disord. 2013;5(3):273–81. Epub 2013/02/16. doi: https://doi.org/10.1007/s12402-012-0100-8. PubMed PMID: 23413201; PubMed Central PMCID: PMCPMC4009378. Surman CB, Biederman J, Spencer T, Miller CA, McDermott KM, Faraone SV. Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study. Atten Defic Hyperact Disord. 2013;5(3):273–81. Epub 2013/02/16. doi: https://​doi.​org/​10.​1007/​s12402-012-0100-8. PubMed PMID: 23413201; PubMed Central PMCID: PMCPMC4009378.
31.
Zurück zum Zitat Reimherr FW, Williams ED, Strong RE, et al. Double-blind, placebo-controlled, crossover study of osmotic release oral system methylphenidate in adults with ADHD with assessment of oppositional and emotional dimensions of the disorder. J Clin Psychiatry. 2007;68(1):93–101. https://doi.org/10.4088/JCP.v68n0113.CrossRefPubMed Reimherr FW, Williams ED, Strong RE, et al. Double-blind, placebo-controlled, crossover study of osmotic release oral system methylphenidate in adults with ADHD with assessment of oppositional and emotional dimensions of the disorder. J Clin Psychiatry. 2007;68(1):93–101. https://​doi.​org/​10.​4088/​JCP.​v68n0113.CrossRefPubMed
32.
Zurück zum Zitat Barkley R, Murphy K. Deficient emotional self-regulation in adults with ADHD: the relative contributions of emotional impulsiveness and ADHD symptoms to adaptive impairments in major life activities. J ADHD Relat Disord. 2010;1(4):5–28. Barkley R, Murphy K. Deficient emotional self-regulation in adults with ADHD: the relative contributions of emotional impulsiveness and ADHD symptoms to adaptive impairments in major life activities. J ADHD Relat Disord. 2010;1(4):5–28.
34.
Zurück zum Zitat Reimherr F, Marchant B, Olsen J, et al. Emotional dysregulation as a core feature of adult ADHD: its relationship with clinical variables and treatment response in two methylphenidate trials. J ADHD Relat Disord. 2010;1(4):53–64. Reimherr F, Marchant B, Olsen J, et al. Emotional dysregulation as a core feature of adult ADHD: its relationship with clinical variables and treatment response in two methylphenidate trials. J ADHD Relat Disord. 2010;1(4):53–64.
35.
Zurück zum Zitat Barkley RA, Fischer M. The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. J Am Acad Child Adolesc Psychiatry. 2010;49(5):503–13.PubMed Barkley RA, Fischer M. The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. J Am Acad Child Adolesc Psychiatry. 2010;49(5):503–13.PubMed
37.
39.
Zurück zum Zitat Canetti L, Berry EM, Elizur Y. 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(2):109–117. Epub 2008/10/25. doi: https://doi.org/10.1002/eat.20592. PubMed Canetti L, Berry EM, Elizur Y. 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(2):109–117. Epub 2008/10/25. doi: https://​doi.​org/​10.​1002/​eat.​20592. PubMed
43.
Zurück zum Zitat Schutte NS, Malouff JM, Bhullar N. The assessing emotions scale. Assessing emotional intelligence. The Springer Series on Human Exceptionality 2009. p. 119–134. Schutte NS, Malouff JM, Bhullar N. The assessing emotions scale. Assessing emotional intelligence. The Springer Series on Human Exceptionality 2009. p. 119–134.
47.
Zurück zum Zitat Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.PubMed Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.PubMed
48.
Zurück zum Zitat Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord. 2012;45(3):428–38. Epub 2011/07/12. doi: https://doi.org/10.1002/eat.20931. PubMed PMID: 21744375; PubMed Central PMCID: PMCPMC3668855. Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord. 2012;45(3):428–38. Epub 2011/07/12. doi: https://​doi.​org/​10.​1002/​eat.​20931. PubMed PMID: 21744375; PubMed Central PMCID: PMCPMC3668855.
50.
Zurück zum Zitat Baumeister RF, Heatherton TF, Tice DM. Losing control: how and why people fail at self-regulation. San Diego, CA: Academic Press; 1994. Baumeister RF, Heatherton TF, Tice DM. Losing control: how and why people fail at self-regulation. San Diego, CA: Academic Press; 1994.
53.
Zurück zum Zitat Cortese S, Vincenzi B. Obesity and ADHD: clinical and neurobiological implications. In: Stanford C, Tannock R, editors. Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. Current Topics in Behavioral Neuroscience. 9. 2011/08/17 ed. Berlin Heidelberg: Springer-Verlag; 2011. p. 199–218. Cortese S, Vincenzi B. Obesity and ADHD: clinical and neurobiological implications. In: Stanford C, Tannock R, editors. Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. Current Topics in Behavioral Neuroscience. 9. 2011/08/17 ed. Berlin Heidelberg: Springer-Verlag; 2011. p. 199–218.
54.
Zurück zum Zitat Pjanic, Muller R, Laimer M, Hagenbuch N, Laederach K, Stanga Z. Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss? J Eat Disord. 2017;5:14. Epub 2017/05/19. doi: https://doi.org/10.1186/s40337-017-0144-4. PubMed PMID: 28515933; PubMed Central PMCID: PMCPMC5430604. Pjanic, Muller R, Laimer M, Hagenbuch N, Laederach K, Stanga Z. Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss? J Eat Disord. 2017;5:14. Epub 2017/05/19. doi: https://​doi.​org/​10.​1186/​s40337-017-0144-4. PubMed PMID: 28515933; PubMed Central PMCID: PMCPMC5430604.
55.
57.
Zurück zum Zitat de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord 2011;133(1–2):61–68. Epub 2011/04/20. doi: https://doi.org/10.1016/j.jad.2011.03.025. PubMed de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord 2011;133(1–2):61–68. Epub 2011/04/20. doi: https://​doi.​org/​10.​1016/​j.​jad.​2011.​03.​025. PubMed
58.
Zurück zum Zitat Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, Shekelle PG Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA 2016;315(2):150–163. Epub 2016/01/13. doi: https://doi.org/10.1001/jama.2015.18118. PubMed Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, Shekelle PG Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA 2016;315(2):150–163. Epub 2016/01/13. doi: https://​doi.​org/​10.​1001/​jama.​2015.​18118. PubMed
Metadaten
Titel
Emotion Self-Regulation Moderates the Association Between Symptoms of ADHD and Weight Loss After Bariatric Surgery
verfasst von
Tamara M. Williamson
Tavis S. Campbell
Jo Ann Telfer
Joshua A. Rash
Publikationsdatum
24.11.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 6/2018
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-3037-3

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