Date Approved


Date Posted


Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School


Committee Member

Karen Saules, Ph.D., Chair

Committee Member

Anne Eshelman, PhD, ABPP

Committee Member

Tamara Loverich, PhD

Committee Member

Ken Rusiniak, PhD


Bariatric surgery is a clinically effective tool that commonly results in sustained weight loss changes for the majority of patients. While bariatric surgery is generally associated with a number of positive health outcomes post-operatively, some popular media outlets and clinical anecdotes have presented concerns about the notion of “addiction transfer” and substance abuse post-bariatric surgery. There is a lack of research, however, in this area. The present study examined the rate of substance abuse in a broad sample of postbariatric surgery patients and examined potential risk factors for the development of substance abuse post-surgery. It was hypothesized that documented risk factors for substance abuse, more generally, would also predict substance abuse among this population. In addition, it was hypothesized that a number of theoretically-driven variables would predict substance abuse among this sample more specifically. For instance, it was hypothesized that those who had high food addiction scores pre-surgery would be more likely to meet criteria for substance abuse post-surgery, thereby supporting the addiction transfer theory. Participants completed a web-based survey assessing retrospective accounts of pre-surgical substance use, eating pathology, family history, and traumatic history, post-surgical substance use, life stressors, and body image, and global trait-like measures such as emotion dysregulation, impulsivity, sensation-seeking, and coping skills. Findings revealed that a subgroup of individuals met criteria for substance abuse post-bariatric surgery; however, the majority of those who met substance abuse criteria post-surgery did not have a history of substance abuse. Family history of substance abuse, poor coping skills, and major life stressors were related to substance abuse post-bariatric surgery, particularly for the new-onset substance abuse group. Contrary to expectations, however, the theory of addiction transfer was not supported. Findings highlight future directions for pre-bariatric assessments and the need for improved follow-up care among post-bariatric surgery patients. Future longitudinal studies with larger sample sizes are needed to better understand both psychological and physiological risk factors for substance abuse development post-bariatric surgery.