Distress Tolerance and Psychological Comorbidity in Patients Seeking Bariatric Surgery

Afton M. Koball, Susan M. Himes, Leslie Sim, Matthew M Clark, Maria L. Collazo-Clavell, Manpreet Mundi, Todd Kellogg, Karen Graszer, Karen Grothe

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction/Purpose: Distress intolerance is characterized by a low threshold for negative emotional experiences and lack of emotion regulation and has been shown to predict various health outcomes. As such, the primary aim of this study was to determine the association between distress tolerance and psychological variables (eating behaviors, mood, substance use, trauma history), completion of bariatric surgery, and post-bariatric surgery weight loss outcomes and follow up with a provider. Materials and Methods: Two hundred forty-eight patients (75 % female, 89 % Caucasian) underwent a multidisciplinary evaluation for bariatric surgery and were assessed for psychiatric disorders via semi-structured clinical interview and psychometric questionnaires. Results: Low distress tolerance was associated with symptoms of depression (p ≤ 0.001), anxiety (p ≤ 0.001), disordered eating behaviors (p ≤ 0.001), substance abuse (p ≤ 0.001), a history of being the victim of childhood sexual abuse (p ≤ 0.001), and with high BMI (p <.05). Patients endorsing higher levels of distress tolerance were more likely to undergo bariatric surgery (p <.01). Distress tolerance was not related to 2-year post-surgical weight loss outcomes or follow up with a provider. Conclusion: The ability to tolerate negative affect may be a variable that differentiates which patients undergo bariatric surgery rather than early postoperative outcomes.

Original languageEnglish (US)
JournalObesity Surgery
StateAccepted/In press - Oct 13 2015


  • Bariatric Surgery
  • Distress Tolerance
  • Eating Disorders
  • Risk for Weight Regain
  • Substance Use

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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