Date of Award

Summer 2019

Document Type


Degree Name

Doctor of Philosophy (PhD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Serina A. Neumann

Committee Director

Barbara A. Cubic

Committee Member

Skye O. Margolies

Committee Member

Scott M. Debb

Committee Member

Kristin E. Heron

Committee Member

Ninoska D. Peterson


Bariatric surgery is a medical procedure that has been found to be an effective option for weight loss. Despite the benefits of bariatric surgery, little is known about the psychosocial factors that may impact weight outcome. The present study attempted to examine patients’ level of perceived stress, depressed mood, and diet, and the association of these factors with percent weight loss in the first 6-months after surgery. Eighty patients completed pre- and 6-months post-operative depressed mood assessment (Patient Quality Health Questionnaire – 7 [PHQ-7]), a perceived stress measure (Cohen’s Perceived Stress Scale – 10 [PSS-10]), and dietary measures (Block Dietary Fruit-Vegetable-Fiber Screener, Block Dietary Fat Screener, Eating and Diet Questionnaire). A protein guideline sheet was also provided to research participants at each visit.

Paired samples t-tests supported pre- and 6-month post-operative significant decrease in depressed mood. Perceived stress was hypothesized to decrease between pre- and 6-month post-operative visits. However, the finding was not supported although the change noted was in the hypothesized direction. To better address the hypothesis of high fat meat consumption and its impact on weight outcome at 6-months after surgery, five high fat items from the Block Dietary Fat screener were identified. A regression analysis model found that there was no statistically significant association between change in consumption of high-fat meat and percent weight loss. Further, the relationship between changes in stress and healthy eating and changes in depressed mood and healthy eating were only significant pre-operatively – not at the 6-month post-operative visit. Lastly, a path analysis indicated no indirect or direct effects of the mediating relationships between changes in depression, stress, healthy diet, and percent weight loss. However, there was a significant direct effect between changes in healthy diet and percent weight loss.

Despite several limitations of this study, these findings provide additional information about the 6-month changes in depressed mood, perceived stress, and diet in bariatric patients. Therefore, this critical post-operative time period warrants further empirical focus, as this is an understudied area in the bariatric population.


The VIRGINIA CONSORTIUM PROGRAM IN CLINICAL PSYCHOLOGY is a joint program of Eastern Virginia Medical School, Norfolk State University, and Old Dominion University.


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