Attachment, eating behaviour and weight loss : a cohort study of patients before and after bariatric surgery.

Primary objective : This study assessed the degree of insecure attachment style in a sample of patients undergoing bariatric surgery compared to a normal weight control group. It also investigated the association between attachment style and eating behaviour within the bariatric group pre-surgery and the impact of attachment on weight loss 6 months post-surgery. Design and method: A cross sectional and cohort quantitative design was used. The bariatric group consisted of 195 patients recruited from a bariatric clinic who were compared with 195 normal weight controls recruited through social media. All participants completed the ECR-R and provided demographic information. The bariatric group also completed measures of control over eating, diet and exercise behaviour, behavioural intentions, and the Power of Food Scale. T-tests and correlations were used for analysis. Outcome and results: The bariatric group demonstrated significantly higher levels of attachment avoidance and lower levels of attachment anxiety than controls. Significant correlations were found between insecure attachment and hedonic wanting of food, and attachment anxiety was significantly correlated with control over eating. No significant correlations were found between attachment and weight loss at 6 months follow up. Conclusion: A potentially causal relationship between attachment and obesity is discussed, as well as the implications for clinical psychology in bariatric services