University of Twente Student Theses


The use of ESM to collect real-time data on emotion and contextual factors in relation to problematic eating behaviour in post-bariatric patients : a longitudinal research methodology

Berg, C.F. van den (2023) The use of ESM to collect real-time data on emotion and contextual factors in relation to problematic eating behaviour in post-bariatric patients : a longitudinal research methodology.

[img] PDF
Abstract:Background: Nowadays, bariatric surgery is the most effective intervention to obtain sufficient weight loss in patients experiencing morbid obesity, showing promising results in reducing the risk of comorbidities and chronic conditions. In order to maintain lasting weight loss, it is of great importance that patients adhere to lifestyle rules recommended postoperatively. Despite the effectiveness of bariatric surgery, post-bariatric patients are not always able to maintain healthy behavioural changes, resulting in weight gain. Eating behaviour appears to be an important aspect for behavioural change in post-bariatric patients. Moreover, emotions and contextual factors play a great role in problematic eating behaviour. The current study aims to investigate the influence of emotions and contextual factors in relation to problematic eating behaviours in post-bariatric patients. In addition, research has been conducted into the usability of an ESM application to see whether this tool can possibly be integrated into bariatric aftercare. Methods: An Experience Sampling Study was conducted among patients who underwent bariatric surgery in 2022 in Hospital Group Twente (ZGT). The application Ethica investigated emotions (anger, hunger and stress), contextual factors (place and activity) and problematic eating behaviours (loss of control (LOC) eating, craving, grazing and dietary relapse) in post-bariatric patients (N= 18). In a 14-day ESM study, respondents had to complete six questionnaires a day that were sent at semi-random times. Linear Mixed Models (LMMs) with a random intercept were used for the statistical analysis. Furthermore, insight was obtained into the usability of Ethica from a patients’ perspective by conducting semi-structured interviews (N= 5). Results: Current research showed that hunger was associated with craving (B=.093, p<.001) and stress was associated with grazing (B=-.008, p=.004). Anger and contextual factors were not associated with LOC eating, craving and grazing (p>.05). In addition, low frequencies of problematic eating were found. LOC eating occurred 7 times, dietary relapse occurred 45 times and grazing occurred 13 times during the 14-day ESM study with 18 participants. The semi-structured interviews showed that the self-reported ESM questionnaires made patients more aware of their eating behaviour. Conclusion: Present study confirms that there is an association between hunger and craving and stress and grazing in post-bariatric patients. Current study found no associations between contextual factors and problematic eating behaviour. The semi-structured interviews indicated that respondents were positive about the usability of the application after surgery and visioned that Ethica could be of added value for bariatric patients in the postoperative phase. This offers perspective for the use of an innovative technology to optimize the aftercare of bariatric patients
Item Type:Essay (Master)
Ziekenhuisgroep Twente (ZGT), Hengelo, Nederland
Faculty:TNW: Science and Technology
Subject:44 medicine, 77 psychology
Programme:Health Sciences MSc (66851)
Link to this item:
Export this item as:BibTeX
HTML Citation
Reference Manager


Repository Staff Only: item control page