The influence of attachment orientation on weight loss, eating behaviour and other health outcomes among patients undergoing bariatric surgery: A scoping review

Abstract

Attachment orientation is a psychological factor concerning our expectations of ourselves and others in interpersonal relationships. An emerging literature has suggested that attachment orientation may influence a range of outcomes associated with bariatric surgery. The purpose of this systematic scoping review was to map the literature and examine the role of attachment orientation in the context of bariatric surgery. Studies conducted with patients who are undergoing or have undergone bariatric surgery, with a measure of attachment orientation and published by 21 st July 2019, were located through electronic searches 35 including Scopus, PubMed and Web of Science. 21180 studies were identified, of which 18 36 were retained for narrative synthesis. The major outcome themes reported were (1) post-37 surgery weight-loss/ body mass index (k = 10), (2) eating behaviour (k = 9), (3) attachment 38 orientation differences in bariatric surgery patients compared with control groups (k = 4) and 39 4) other mental and physical health outcomes (k = 12). Overall, the results showed that there was little evidence to suggest that poor attachment orientation is predictor of weight-loss following surgery. There was evidence to suggest that poorer attachment orientation relates to poorer eating behaviours both before and after surgery, that patients undergoing bariatric surgery are more likely to have a poorer attachment orientation and attachment orientation is related to mental health outcomes but not physical health outcomes for patients. However, where relationships were identified, there were considerable inconsistencies regarding the dimension of attachment orientation that drove the relationship. Future studies should consider appropriate sample sizes for studies, replication of key findings and longer durations for longitudinal studies.

Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory

“…Twelve participants took part in the study, most of them female (11), married (8), with complete higher education (8) and with a mean age of 37.5 years. The two categories and their subcategories, built based on data analysis, are presented in Chart 1.…”

“…Because it has a multifactorial cause, obesity involves genetic, environmental, lifestyle and emotional factors; for this reason, different methods have been used for its treatment, aiming at an effective result (1,6) . Among the treatments, nutritional guidance with the introduction of healthy foods, adherence to the practice of regular physical activity, psychological support and medical treatment with bariatric surgery when results are not achieved with the previous options stand out (7)(8)(9) .…”

“…Bariatric surgical interventions have been used as the fastest method. They guarantee weight loss and the control of associated diseases in morbidly obese people, maintaining the long-term result (7)(8) . Thus, bariatric surgery can be an opportunity for social reintegration in the face of situations of discrimination, intolerance, and exclusion, caused by morbid obesity.…”

Parent–Infant Attachment Insecurity and Emotional Eating in Adolescence: Mediation through Emotion Suppression and Alexithymia

“…By focusing on pathological eaters, it remains unclear whether attachment insecurity is linked to eating behaviors in the general population [ 13 ]. The few studies that did investigate attachment security and EE, indicated that attachment insecurity increases the risk for EE in bariatric surgery candidates and patients [ 20 , 21 , 22 ], and that EE mediated the association between attachment anxiety and body mass index (BMI) [ 23 ], but not between disorganized and BMI [ 15 ]. As such, the first aim was to longitudinally investigate if attachment security observed in infancy predicts EE in adolescence.…”