Two studies investigated how discrepancies between implicit and explicit self‐esteem are related to mental and physical health. We found that, compared to congruent self‐esteem, discrepant self‐esteem was related to more anger suppression, a more depressive attributional style, more nervousness, and more days of impaired health. The result applies not only to fragile (high explicit, low implicit) self‐esteem, but also to damaged (low explicit, high implicit) self‐esteem. These findings show that high implicit self‐esteem is not necessarily advantageous. In individuals with low explicit self‐esteem having high implicit self‐esteem was related to more health problems than having low implicit self‐esteem. Taken together the results suggest that discrepancies between implicit and explicit SE are detrimental to mental and physical health. Copyright © 2007 John Wiley & Sons, Ltd.

Recent research has provided evidence that bariatric surgery maximizes long-term weight loss in patients with severe obesity. However, a substantial number of patients experience poor weight loss outcome and weight regain over time. Post-operative behavioural management may facilitate long-term weight control in bariatric surgery population. The objective of this systematic review and meta-analysis was to determine the effects of post-operative behavioural management on weight loss following bariatric surgery. Eligible articles were systematically searched in electronic databases. Among the 414 citations, five randomized controlled trials, two prospective and eight retrospective cohort trials analysing behavioural lifestyle interventions and support groups fulfilled the inclusion criteria. The main finding is that behavioural management had a positive effect on weight loss following surgery. In 13 studies, patients receiving behavioural management had greater weight loss than patients receiving usual care or no treatment. A meta-analysis of five randomized controlled trials suggests greater weight loss in patients with behavioural lifestyle interventions compared with control groups. Post-operative behavioural management has the potential to facilitate optimal weight loss following bariatric surgery, but conclusions were limited by the small and heterogeneous samples of studies. A more rigorous empirical evaluation on its clinical significance is warranted to improve effectiveness of bariatric surgery.

Recent research has provided increasing evidence that discrepancies between implicit and explicit self‐esteem (SE) are related to defensiveness. However, only one pattern, called fragile SE (a combination of high explicit and low implicit SE), has been the focus of research so far. Relatively little attention has been paid to the second possible SE discrepancy (low explicit/high implicit). We propose that both types of discrepancies are maladaptive, because they indicate a lack of integration in self‐representation. We conducted two studies on the correlates of discrepant SE in the sphere of defensiveness. We hypothesized that persons with discrepant SE exhibit more defensive behaviour than individuals with congruent SE. In two student samples, explicit SE was measured by means of the Multidimensional Self‐Esteem Scale. Implicit SE was measured with the Name Letter Technique (Study 1) and an Implicit Association Test (Study 2). In Study 1 (N = 102) we examined effects of implicit and explicit SE on defensive reactions to ambiguous statements. For this purpose, we adapted the Ambiguous Statements Task (AST, Tafarodi, 1998), a procedure that measures participants' tendency to interpret ambiguous expressions in a positive vs negative manner. We found that the combination of low explicit SE and high implicit SE was associated with a more positive interpretation of the ambiguous statements. Study 2 (N = 87) investigated the effects of discrepant SE on reactions to SE threat in an experimental setting. The time participants spent reading positive or negative social feedback was used as an unobtrusive measure of defensiveness. We found that people with discrepant SE went through the negative feedback faster than people with congruent SE. In sum, the studies provide converging evidence that both kinds of discrepancies between implicit and explicit SE are related to defensive behaviour.

BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity.