Summar Reslan

Date Approved

8-28-2012

Date Posted

4-22-2013

Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School

Psychology

Committee Member

Karen K. Saules, Ph.D., Chair

Committee Member

Mark Greenwald, Ph.D.

Committee Member

Thomas Schmitt, Ph.D.

Committee Member

Tamara Loverich, Ph.D.

Abstract

Bariatric surgery is rapidly gaining acceptance among the morbidly obese population, yet studies assessing variables associated with post-surgical outcomes have yielded inconsistent findings. The purpose of this investigation was to assess the association between the relative reinforcing value of food (RRV-F), delay discounting for food (DD-F), and other eating-related and non eating-related variables to post-bariatric surgery percent total weight loss (%TWL) and substance-related outcomes. Participants were a convenience sample of 147 adults with a history of Roux-en-Y gastric bypass surgery. Using online survey methodology, variables that may contribute to post-surgical %TWL and substance use outcomes were assessed: the RRV-F, DDF, quality of life, and other eating-related variables (food addiction, binge eating, dietary restraint, disinhibition, craving, grazing, nocturnal eating, and emotional eating). The RRV-F was significantly associated with post-bariatric surgery %TWL, while the DD-F was not found to be a valid measure of food-related impulsivity among post-bariatric surgery patients. Weight loss and substance-related outcomes were inversely related, as those who achieved less weight loss were more likely to endorse symptoms of a probable post-surgical substance use disorder (SUD). Dietary restraint and disinhibition were found to influence %TWL, while the eating related variables found to contribute most significantly to a probable post-surgical SUD were nocturnal eating, food addiction, subjective feelings of hunger, and environmental sensitivity to food cues. Family history of substance abuse was also strongly associated with endorsing symptoms of a probable post-surgical SUD. Regarding %TWL outcomes, results suggest strongly advising post-bariatric surgery patients to avoid substance use. With respect to endorsing symptoms of a probable SUD, results have practical implications in that family history of SUD can be easily assessed, and at-risk patients can be advised accordingly. In addition, those who develop post-bariatric surgery SUD appear to have stronger cognitive and behavioral responses to food, providing some support for the concept of "addiction transfer."

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