Background

Pain catastrophizing (PC) is a negative cognitive response - including rumination, magnification, and hypervigilance - to perceived or actual pain and has been associated with worse surgical outcomes; however, the relationship of PC and eating experiences in patients with obesity is poorly understood. We explored this relationship by surveying patients seeking surgical management of obesity with the Body-Q Eating Scales, which assess eating-related (ER) behavior (eating habits, snacking frequency), ER distress (emotions after eating), and ER symptoms (nausea, vomiting, pain).

Methods

All patients at a major academic institution presenting for surgical management of obesity were given the Body-Q Eating Scales and Pain Catastrophizing Scale (PCS). Body-Q scores were summed, and individual questions of each domain were dichotomized between presence and absence of items. Scores of the PCS were dichotomized into presence or absence of PC. Pearson's correlation was used to evaluate the relationship between PC and Body-Q.

Results

Overall, 141 patients completed both the Body-Q and PCS questionnaires with 83% compliance. Seventy-two percent of the cohort reported PC behaviors. The baseline demographics of those with and without PC did not significantly differ (Table). Those with PC had significantly worse physical function (p<0.001), ER symptoms (p=0.009), ER distress (p<0.001), but similar ER behavior (Figure).

Conclusions

PC is associated with worse ER symptoms, ER distress, and physical function in patients seeking bariatric surgical care. These findings suggest that PC is an important predictor of eating-related experiences and can be used to identify patients who may require more aggressive preoperative psychosocial support.