Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic

Abstract

Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk.

Keywords: COVID-19; anxiety; eating disorder; mental health; obesity; obesity surgery.

Figure 1

Generalized anxiety as a risk factor for increased levels of dysfunctional COVID-19-specific eating after obesity surgery. Group-wise box-plots indicate medians and interquartile ranges (see supplemental material for illustration of non-splitted continuous data). While for participants with no or mild manifestations of generalized anxiety (GAD-17 scores of 0 to 4, or 5 to 9, respectively), no increase in DCSEB is notable, and individuals with moderate to severe levels of anxiety (GAD-7 > 9) show increased DCSEB after obesity surgery. Whiskers extend to the most extreme data point unless there are data 1.5 inter-quartile-ranges away from the first or the third quartile, respectively. Data points beyond that are shown as a black dot.