Researchers studied 818 people preparing for weight loss surgery to understand how struggling to get enough food affects their eating habits and emotions. They found that about 1 in 5 patients couldn’t reliably access food. These patients reported feeling more emotional distress and physical discomfort related to eating, even though their actual eating behaviors were similar to others. The study suggests that doctors should screen patients for food insecurity before surgery and offer extra support to those who struggle to afford or access food.

The Quick Take

  • What they studied: Whether people who can’t reliably get enough food experience more eating-related emotional problems and physical symptoms when preparing for weight loss surgery
  • Who participated: 818 adults (80% of those invited) who came to a clinic to be evaluated for weight loss surgery. About 1 in 5 reported struggling to get enough food in the past year.
  • Key finding: People without reliable food access reported significantly more emotional distress (like embarrassment or anxiety about eating) and physical symptoms (like pain or bloating), but their eating behaviors were similar to others. This difference was statistically significant (P<0.05), meaning it’s unlikely to be due to chance.
  • What it means for you: If you’re considering weight loss surgery and struggle to afford or access food, you may benefit from extra emotional and nutritional support before and after your procedure. Doctors should ask about food access as part of preparing for surgery.

The Research Details

This was a cross-sectional study, which means researchers collected information from people at one point in time rather than following them over months or years. All patients coming to a weight loss surgery clinic completed two questionnaires: a simple two-question screening tool about food insecurity (whether they had enough food to eat in the past year) and the BODY-Q, a detailed survey about eating-related experiences.

The BODY-Q asked patients to rate their experiences on a scale from 0 to 100, with 100 being the best possible health. It measured three areas: eating behaviors (like feeling out of control while eating), emotional distress (like feeling embarrassed about eating), and physical symptoms (like bloating or pain). Researchers then compared scores between people with and without food insecurity using statistical tests.

This approach is valuable because it captures real-world experiences from actual patients preparing for surgery. By using validated questionnaires (tools that have been tested and proven reliable), the researchers could measure both the presence of food insecurity and its emotional and physical effects. This helps identify which patients might need extra support.

The study had a strong response rate (80% of invited patients completed surveys), which means the results likely represent the actual patient population. Both tools used are validated, meaning they’ve been tested and proven to accurately measure what they claim to measure. However, because this is a snapshot in time rather than following people over time, we can’t prove that food insecurity causes the emotional and physical problems—only that they occur together.

What the Results Show

Of the 818 patients surveyed, 174 (about 21%) reported food insecurity—meaning they didn’t have reliable access to enough food in the past year. This is notably higher than the general U.S. population rate.

Patients with food insecurity reported significantly worse emotional distress related to eating. This included feelings like embarrassment, anxiety, and distress about their eating. They also reported more physical symptoms like pain, bloating, and digestive discomfort.

Interestingly, the actual eating behaviors (like feeling out of control while eating) were similar between the two groups. This suggests that food insecurity affects how people feel emotionally and physically about eating, rather than changing what or how much they eat.

These differences were statistically significant, meaning they’re unlikely to be due to chance alone.

The study identified food insecurity as a common issue in this patient population—affecting more than 1 in 5 people. This suggests that weight loss surgery clinics should routinely screen for food insecurity as part of patient evaluation. The findings also suggest that emotional and physical symptoms may be more sensitive indicators of food insecurity’s impact than behavioral changes.

Previous research has shown that food insecurity is linked to worse health outcomes in general populations, but this is one of the first studies specifically examining how it affects people preparing for weight loss surgery. The findings align with broader research showing that food insecurity creates stress and anxiety, which can manifest as physical symptoms. This study adds important evidence that food insecurity should be considered when preparing patients for surgery.

This study captures only a moment in time, so we can’t determine whether food insecurity causes the emotional distress or if people with emotional distress are more likely to experience food insecurity. The study doesn’t include information about why people experienced food insecurity (poverty, job loss, other factors) or how long they’d been food insecure. The results come from one clinic, so they may not apply to all weight loss surgery patients. Additionally, the study relies on self-reported information, which could be affected by patients’ willingness to disclose sensitive information about food access.

The Bottom Line

Healthcare providers should screen all patients considering weight loss surgery for food insecurity using simple questions about food access. For patients with food insecurity, providers should offer: (1) referrals to food assistance programs, (2) nutritional counseling that accounts for limited food access, and (3) psychological support to address eating-related emotional distress. These recommendations are supported by this research but should be combined with other evidence-based approaches. Confidence level: Moderate (based on this single study).

This matters most for: people considering weight loss surgery who struggle to afford or access food; healthcare providers and surgeons preparing patients for weight loss surgery; public health officials designing support programs for low-income patients. People with reliable food access may still benefit from the emotional support recommendations, but the findings are most directly relevant to those experiencing food insecurity.

Screening for food insecurity should happen before surgery. Emotional and physical symptom improvements from support programs may take weeks to months to become noticeable. Long-term benefits would be assessed over the months and years following surgery.

Want to Apply This Research?

  • Track weekly eating-related emotional distress using a simple 0-10 scale (0=no distress, 10=extreme distress). Also monitor physical symptoms like bloating, pain, or digestive discomfort on the same scale. Record whether you had reliable access to the foods you needed that week.
  • If you’re food insecure, use the app to: (1) log food assistance resources you access (food banks, SNAP benefits, community programs), (2) track which affordable foods make you feel physically better, (3) record emotional triggers related to eating and food access, (4) set reminders to use food assistance programs or reach out for support.
  • Weekly check-ins on emotional distress and physical symptoms related to eating. Monthly reviews of food access patterns and use of support resources. Track changes over 8-12 weeks to see if accessing food assistance or support programs improves your emotional and physical symptoms.

This research describes associations between food insecurity and eating-related emotional and physical symptoms in people preparing for weight loss surgery. It does not prove that food insecurity causes these symptoms. This information is for educational purposes and should not replace professional medical advice. If you’re experiencing food insecurity or emotional distress related to eating, please speak with your healthcare provider, surgeon, or a mental health professional. If you need food assistance, contact your local food bank, SNAP office, or call 211 (in the U.S.) for resources in your area.