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Boredom and stress as momentary predictors of loss of control eating after metabolic and bariatric surgery: a longitudinal investigation

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Surg Obes Relat Dis. 2025 Oct 10:S1550-7289(25)00946-3. doi: 10.1016/j.soard.2025.09.008. Online ahead of print.

ABSTRACT

BACKGROUND: Loss of control eating (LOCE) is associated with adverse clinical outcomes after metabolic and bariatric surgery (MBS); however, current understanding of factors that predict LOCE is incomplete. This study is the first to investigate boredom and stress as predictors of LOCE following MBS.

OBJECTIVES: To use ecological momentary assessment (EMA) to evaluate boredom and stress as predictors of LOCE over 3 years following MBS.

SETTING: University hospitals; United States.

METHODS: Adults (N = 150) who underwent MBS completed a study visit followed by a 1-week EMA protocol at 1-year, 2-year, and 3-years post-MBS (with 143 participants contributing data at year 1, 110 at year 2, and 91 at year 3). During the EMA protocol, participants provided ratings of boredom, stress, and LOCE five times per day.

RESULTS: Stress and boredom were associated with LOCE when controlling for year since surgery. Regarding variability in associations over time, at the within-person level, momentary boredom predicted more severe LOCE, but only at 2 years post-MBS. Momentary stress predicted more severe LOCE at 2- and 3-years post-MBS, with no change between these years. At the between-person level, participants with higher boredom reported more severe LOCE during the EMA protocol at 2- and 3-years post-MBS, with the strongest association 3-years post-MBS. Participants with higher stress reported more severe LOCE during the EMA protocol each year following MBS, with the strongest association at 2-years post-MBS.

CONCLUSIONS: Boredom and stress predict more severe LOCE, particularly 2-3 years post-MBS, highlighting this period as an opportunity for intervention.

PMID:41176457 | DOI:10.1016/j.soard.2025.09.008

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