Psychology of Obesity Flashcards

A patient reports eating large quantities of food late at night while feeling unable to stop, followed by intense guilt, but never uses compensatory behaviors like purging. Which condition does this pattern most suggest?

Answer: Binge eating disorder

Recurrent binges with loss of control and distress, without compensatory behaviors, define binge eating disorder.

According to the transtheoretical model, a patient who says 'I know my weight is a problem, and I'm thinking about making changes in the next few months' is in which stage of change?

Answer: Contemplation

Contemplation is marked by awareness of the problem and intention to change within about six months, without concrete steps yet.

Which psychological mechanism best explains why chronic stress often leads to increased intake of high-fat, high-sugar foods?

Answer: Cortisol-driven reward-seeking that makes palatable foods temporarily dampen the stress response

Elevated cortisol enhances the reward value of palatable 'comfort' foods, which transiently blunt the stress response and reinforce emotional eating.

A bariatric counselor notices a patient consistently describes herself as 'disgusting' and avoids mirrors and social events. These features are most characteristic of which construct?

Answer: Body image disturbance

Negative self-evaluation of appearance with avoidance behaviors reflects body image disturbance, common in patients with obesity.

Which statement best describes the relationship between depression and obesity supported by longitudinal research?

Answer: The relationship is bidirectional, with each condition increasing the risk of the other

Meta-analyses show a reciprocal relationship: obesity raises depression risk and depression raises obesity risk.

In classical conditioning terms, a patient who feels strong cravings whenever she sits on her living-room couch, where she habitually snacks, is experiencing what phenomenon?

Answer: Cue-induced (conditioned) craving triggered by an environmental stimulus

The couch has become a conditioned stimulus that elicits craving through repeated pairing with eating.

Which cognitive distortion is a patient displaying when she says, 'I ate one cookie, so my whole diet is ruined and I might as well binge'?

Answer: All-or-nothing (dichotomous) thinking

Viewing a minor lapse as total failure is classic all-or-nothing thinking, a driver of the abstinence violation effect.

A counselor using motivational interviewing hears a patient say, 'I really want to be healthier for my kids, but I love food too much.' What is the most appropriate initial response?

Answer: Reflect the ambivalence and explore the patient's own motivations for change

Motivational interviewing responds to ambivalence with reflective listening to elicit the patient's own change talk rather than confrontation or advice.

Which finding is most consistent with the concept of weight stigma internalization?

Answer: A patient applies negative societal stereotypes about weight to herself, worsening depression and disordered eating

Internalized weight bias means adopting society's anti-fat stereotypes toward oneself, which is linked to poorer mental health and eating outcomes.

A patient who was denied a job promotion says the interviewer kept glancing at her body. Research suggests experiences of weight discrimination most often lead to which behavioral outcome?

Answer: Increased eating and avoidance of exercise, promoting further weight gain

Studies show weight discrimination paradoxically increases obesity risk by triggering stress eating and exercise avoidance rather than motivating weight loss.

Which childhood experience shows the strongest documented association with adult obesity in the Adverse Childhood Experiences (ACE) research?

Answer: Cumulative exposure to abuse and household dysfunction

The ACE studies found a dose-response relationship between cumulative childhood adversity and adult obesity risk.

A patient says she eats when she is bored, lonely, or anxious rather than when physically hungry. The counselor's first skill-building target should be which of the following?

Answer: Helping her differentiate emotional triggers from physiological hunger cues

Interventions for emotional eating begin with building awareness that distinguishes emotional triggers from true hunger.

In the dual-process model of eating behavior, obesogenic food choices are most often attributed to what imbalance?

Answer: Strong automatic/impulsive reactions to food cues overriding weaker reflective self-control

Dual-process theory holds that automatic impulsive responses to palatable food cues frequently overpower deliberate, goal-directed control.

A patient reports that food is the only reliable source of pleasure in her life. Which counseling strategy directly addresses this pattern?

Answer: Behavioral activation to build alternative rewarding activities

Behavioral activation expands the patient's repertoire of non-food rewards, reducing reliance on eating for pleasure.

Six months after gastric bypass, a patient reports drinking alcohol nearly every evening despite rarely drinking before surgery. This pattern is most consistent with which recognized post-bariatric phenomenon?

Answer: Addiction transfer (cross-addiction) replacing food-related reward

Addiction transfer describes substituting alcohol or other compulsive behaviors for food after bariatric surgery, aided by altered alcohol pharmacokinetics.

During a pre-surgical psychological evaluation, which finding would most warrant delaying bariatric surgery for further treatment?

Answer: Active, untreated bulimia nervosa with frequent purging

Active purging-type eating disorders are a contraindication requiring stabilization before surgery, unlike treated past depression or normal procedural anxiety.

A post-bariatric patient who lost 120 pounds still perceives herself as her pre-surgery size and turns sideways through doorways. This lag is best described as what?

Answer: Phantom fat phenomenon, a delayed updating of body image after rapid weight loss

The 'phantom fat' phenomenon refers to persistence of the larger body schema after massive weight loss, which typically improves gradually.

Which patient behavior after sleeve gastrectomy most strongly suggests 'grazing,' a pattern linked to poorer weight outcomes?

Answer: Eating small amounts of food continuously throughout the day without planned meals

Grazing—repetitive, unplanned nibbling across the day—circumvents surgical restriction and predicts weight regain.

A patient becomes distressed when her spouse begins criticizing her new eating habits and discouraging her gym visits after surgery. Which concept best explains the spouse's behavior?

Answer: Relationship sabotage stemming from disrupted couple dynamics as the patient changes

Significant weight loss can threaten established relationship roles, leading partners to consciously or unconsciously undermine the patient's changes.

Which psychological outcome trajectory is most commonly observed in the first two to three years after bariatric surgery?

Answer: Initial improvement in mood and quality of life, with risk of decline as weight loss plateaus

Most patients experience a psychosocial 'honeymoon' that can fade around 18-36 months when weight stabilizes or regain begins.