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Investigating potential risk factors post-bariatric surgery

Markin USRP scholar looks at how Adult ADHD and emotional regulation deficits interfere with weight loss  


Tamara Williamson is investigating how various psychological, social, motivational and behavioral factors can influence success rates of bariatric surgery patients. Photo by Nikki Reimer

By Heath McCoy

Why did a research study on the outcomes following weight loss surgery become focused on patients with Adult ADHD?

Clinical psychology MSc student Tamara Williamson, who led the study, will address this on Friday (Sept. 29) when she gives her presentation at the Markin USRP Student Research Symposium (1:30 p.m. in the Rozsa Centre’s Husky Oil Great Hall).

Williamson, who received her undergraduate degree in June, took part in the Markin Undergraduate Student Research Program (USRP) in Health & Wellness over the summer, which allowed her to further pursue her research project, began the previous year.  

Under the tutelage of psychology professor Tavis Campbell, Williamson has been investigating how various psychological, social, motivational and behavioral factors can influence the success rates of patients after they’ve had bariatric surgery (weight loss surgery). Because impulse control and emotional eating have been linked to obesity, Williamson’s study focused on emotional regulation and impulsivity/inattention as key risk factors following bariatric surgery.

Williamson points out that inattention and impulsivity are recognized as symptoms of ADHD (attention deficit hyperactivity disorder). Emotional regulation deficits, on the other hand, does not fall within the standard definition of ADHD. However, recent theories of adult ADHD suggest that emotional regulation deficit may actually be “one of the core diagnostic feature of ADHD,” Williamson says. “It’s true that a large subset of people with ADHD do demonstrate low emotional regulation.”

Williamson questioned whether or not the interaction of these factors (emotional regulation and impulsivity/inattention) might impact a patient’s continued success after bariatric surgery.

“We wondered if someone who has strong symptoms of ADHD but good emotional regulation might have an easier time with weight loss than someone who has both ADHD symptoms and low emotional regulation,” Williamson says. “And that’s what we ended up observing.”

“This suggests that people who experience both of these conditions may have a more difficult time losing weight after bariatric surgery than people who only experience one, or, neither of these conditions.”

For the study, Williamson recruited 65 patients who were on a waiting list to undergo bariatric surgery. She conducted follow-ups with these patients at the six-month and one year mark, post-surgery.

Williamson feels her study could have important consequences.

“Bariatric surgery is a big procedure and there’s a lot of costs, time and resources associated with it, so before people have the surgery they undergo a psychological screening process,” she explains. “This is not necessarily to screen them out or disqualify them, but rather to identify areas where they may need help, where an intervention may be necessary to improve their chances for success after the surgery.”

“In the pre-screening, ADHD is identified as a risk factor for problems post-surgery. It is not typical for emotion regulation to be directly assessed. But maybe it’s important to look at these things together, and if somebody has high symptoms of impulsivity and inattention and also emotional regulation issues, it may be crucial to help them after their surgery.”

Williamson says she’s flattered at having been selected as one of four presenters at the Markin USRP Student Research Symposium (out of 40 Markin scholars for the summer of 2017).

“I would encourage any undergraduate who is interested in research – especially if you’re thinking about grad school or a career in academia – to absolutely get involved with a lab and apply for these summer programs,” says Williamson. “It’s prepared me really well for grad school. Getting to work with patients at the undergrad level was a really special opportunity. I can’t stress how valuable the Markin USRP program has been.”

For more information about the Markin USRP in Health and Wellness visit www.ucalgary.ca/usrp