JMIR Publications

ABSTRACT

Background:

Lifestyle modification is essential to achieve and maintain successful outcomes after bariatric surgery. Emotions, physical states, and contextual factors are considered important determinants of (maladaptive) eating behavior, emphasizing their significance in understanding, and addressing weight management. In this context, experience sampling methodology (ESM) offers promise for measuring lifestyle and behavior in the patient’s natural environment. Nevertheless, there’s limited research on its feasibility, and association among emotions and problematic eating behavior within the population after bariatric surgery.

Objective:

The present study aims to examine the feasibility of ESM in the population after bariatric surgery regarding emotions, physical states, contextual factors, and problematic eating behavior, and to explore the temporal association among these variables.

Methods:

An experience sampling study was conducted in which participants rated their current affect (positive and negative), physical states (disgust, boredom, fatigue, and hunger), contextual factors (where, with whom, and doing what), and problematic eating behavior (i.e. grazing, dietary relapse, craving, and binge eating) via smartphone-based ESM questionnaires at six semi-random times daily for 14 consecutive days. Feasibility was operationalized as the study’s participation rate and completion rate, compliance in answering ESM questionnaires, and response rates per day. At the end of the study period, patients reflected on the feasibility of ESM in semi-structured interviews. Generalized estimation equations were conducted to examine the temporal association between emotions, physical states, contextual factors, and problematic eating behavior.

Results:

The study’s participation rate was 10% (n = 25), with a completion rate of 83%. Overall compliance was 56%, varying from 13% to 89% per participant. Total response rates per day declined from 65% to 52% over the 14-day study period. According to the interviews, ESM was considered feasible and of added value. Temporal associations were found for hunger and craving (OR 1.04, 95% CI 1.00–1.07), and for positive affect and grazing (OR 1.61, 95% CI 1.03–2.51).

Conclusions:

In this exploratory study, patients after bariatric surgery were not amenable to participate. Only a small number of patients was willing to participate. However, those who participated found it feasible and expressed satisfaction with it. Temporal associations were identified between hunger and craving, as well as between positive affect and grazing. However, no clear patterns were observed among emotions, physical states, context, and problematic eating behaviors.