IMPACT OF RELATIONSHIP FUNCTIONING AND PATIENT MOTIVATION ON ADHERENCE AND WEIGHT LOSS AFTER BARIATRIC SURGERY

Background: Bariatric surgery is the most successful intervention to treat severely obese individuals, yet there is significant variability in surgical outcome (Hsu et al., 1998, Sarwer, Wadden, & Fabricatore, 2005). Success primarily depends on patients’ ability to make and maintain recommended changes to their lifestyle after surgery. Patients’ ability to make and maintain changes to behavior is impacted by elements of the socioenvironmental context. Prior research on a number of different medical populations suggests that an individual’s partner or spouse may facilitate or hinder behavior change (Sher et al, 2011). Study Aim: The current study examined the role of relationship functioning on patients’ motivation for and adherence to health behavior changes and weight loss (%EWL) after bariatric surgery. Based on self-determination theory, it was hypothesized that better relationship functioning, higher levels of autonomous motivation to make lifestyle changes, and less emotional eating (EE) would be associated with better adherence and %EWL after bariatric surgery. Procedure: Participants were 111 women who had undergone a bariatric procedure at least 2 years prior to study participation and who were also in a monogamous relationship for at least six months. Participants completed a series of online questionnaires that assessed relationship functioning, motivation, EE, adherence to recommended changes after surgery, and %EWL. Results: Results indicated that better relationship functioning and higher levels of autonomous motivation were directly associated with better adherence to recommended changes postsurgery. Better adherence to recommended eating behaviors was related to higher %EWL, and both relationship functioning and autonomous motivation were indirectly x associated with %EWL through their impact on eating behavior adherence. Emotional eating was negatively associated with both %EWL and eating behavior adherence. Conclusions: These findings indicate that both individual (motivation, EE) and couples factors (relationship functioning) directly impact patient outcome after bariatric surgery. Clinical application, limitations, and future directions are discussed.PH.D in Psychology, July 201