Marital Factors Associated with Weight-Related Behavior in Bariatric Surgery Patients

Obesity is a major health concern in the United States. Whereas bariatric surgery is effective, 10-40% of post-operative patients struggle to reach or maintain their goal weight (Elder & Wolfe, 2007). The current study investigated the within-person relations between marital quality and weight-related behaviors using a daily diary design. Length of relationship, time since surgery, and participant sex were explored as moderators. Participants were 94 post-operative bariatric surgery patients. Eligible participants completed an online baseline questionnaire, followed by a one-week online daily diary in which they responded to questions about the quality of their marriage, whether they engaged in physical activity, and whether they adhered to their diet that day. Multilevel models were used to test for same-day and next-day associations. A within-person positive, bidirectional association between marital satisfaction and physical activity on the same day and on the following day was found; however, after correcting for multiple tests, only physical activity predicting marital satisfaction on the same day remained significant. There was a between-person negative, bidirectional association between average levels of marital satisfaction and grazing behavior. Lastly, there was a between-person negative association between spousal reinforcing support and grazing and eating past the point of feeling full on the same day. Relationship length moderated the relation between meal planning and reinforcing support on the same day, as well as physical activity and constructive communication on the following day. Sex differences were found for the relation between physical activity and marital satisfaction on the same day, as well as sexual activity and physical activity on the next day. Findings from this study provide support for bidirectional relations between marital quality and weight-related behavior and provide preliminary support for treatments that target improving marital quality in conjunction with weight-specific treatments