Overvaluation of Weight and Shape Among Weight Loss Surgery Candidates

Overvaluation of shape and weight is a measure of the degree to which an individual’s self-evaluation is influenced by their shape and weight. Among individuals with eating disorders, this construct has been associated with elevated levels of eating pathology and psychological distress. Similarly, weight loss surgery candidates often report high levels of eating pathology, including loss of control eating, in addition to elevated levels of depression. Although studies have found poorer outcomes among those who endorse overvaluation of shape and weight in addition to loss of control eating as compared to those who deny overvaluation of shape and weight, the degree to which overvaluation of shape and weight is associated with disordered eating pathology, depression, psychosocial functioning, and self-esteem among weight loss surgery candidates has not been examined. The goals of the current study were to further elucidate these associations, including the degree to which frequency of loss of control eating episodes mediates associations. Data were analyzed from 88 individuals seeking bariatric surgery. Overvaluation of shape and weight was highly prevalent, with approximately 49% of the sample endorsing their weight and/or shape had a significant impact on their self-evaluation. The results of correlational analyses supported a link between overvaluation of shape and weight and higher levels of eating pathology, including more frequent loss of control eating episodes and disordered eating attitudes, in addition to poorer psychosocial functioning as indicated by greater psychosocial impairment, depression, and lower self-esteem. While frequency of loss of control eating episodes partially mediated associations between overvaluation of shape and weight and global eating pathology, it was not a significant mediator of the associations between overvaluation of shape and weight and shape/weight concerns, weight-related psychosocial functioning, self-esteem, or depression. These findings underscore the importance of assessing pre-surgical levels of overvaluation of shape and weight among individuals seeking bariatric surgery and suggest the importance of evaluating these attitudes and behaviors following surgery