Year In Review

Behavioral and Psychosocial Predictors of Adherence to Dietary Recommendations: One-year Post-bariatric Surgery

Susan Wnuk, Ph.D., C. Psych
Psychologist, Bariatric Surgery Program
Assistant Professor, Dept. of Psychiatry, University of Toronto
University Health Network, Toronto Western Hospital
Toronto, ON

Dr. Susan Wnuk is a clinical psychologist at the University Health Network Bariatric Surgery Program in Toronto and an Assistant Professor at the University of Toronto Department of Psychiatry. She provides clinical care to pre and post-bariatric surgery patients, supervises students, and conducts research. Her current areas of interest are pre and post-surgery psychosocial functioning and the effectiveness of mindfulness and behavioural interventions for bariatric surgery patients. She is involved in research projects investigating psychosocial predictors of outcome in bariatric surgery patients and the effectiveness of cognitive-behavioural and mindfulness treatments for this population that are delivered in-person and remotely. 

Dr. Wnuk graduated from York University in Toronto and prior to joining the Bariatric Surgery Program in 2010, she worked in hospital-based eating disorder and borderline personality disorder programs. She facilitates workshops for professionals and presents at research conferences at the local, national and international levels.

Presentation Overview:

Adherence to dietary guidelines is critical for optimizing outcomes post-bariatric surgery, yet many patients have difficulty with adherence. The purpose of this study was to examine pre-surgery predictors of adherence to dietary guidelines and to identify problematic eating behaviours. We completed a prospective cohort study of adult participants who underwent Roux-en-Y gastric bypass (n=323) or sleeve gastrectomy (n=25) between 2013 and 2017. Predictors were pre-surgery demographics, pre-surgery dietary adherence, and mental health symptoms. Pre-surgery, 75.9% of participants’ eating was classified non-adherent. One-year post-surgery, 41.7% were non-adherent, a significant difference (p<0.05). The most common problematic dietary behavior was insufficient protein intake (32.4%). In the univariate analysis, predictors of post-surgery dietary adherence were pre-surgery dietary adherence (p = 0.02), perceived social support (p = 0.01), emotion regulation (p=0.01), and anxious attachment (p < 0.01). In the multivariate analysis, anxious attachment (p<0.01) and male gender (p=0.03) were significant.