Effects of Social Inclusion and Exclusion in Obesity Surgery Patients: Emotional and Eating Changes after Cyberball Tasks

Abstract Background Social cognition and temperamental and interpretative styles play a significant role in the outcome of bariatric surgery. This study aims to assess how obesity surgery patients evaluate social inclusion and exclusion through a ball-tossing game called Cyberball and examine the influence of early maladaptive schemas on evaluative skills. MethodsThirty-four patients with a history of bariatric interventions for severe obesity and 44 controls were recruited for this study. A psychological evaluation was performed before and after the Cyberball task. ResultsIn the ostracism condition, significant differences were seen across all the patients' fundamental psychological needs with less perceived ostracization (p = 0.001) even if they recognized less interaction via fewer ball tosses. Moreover, the ostracism paradigm resulted in patients experiencing a higher urge to binge (p = 0.010) and a higher urge to restrain (p = 0.012) than controls. The emotional evaluation led to a modification of the participants feelings in both patients and controls after inclusion or exclusion, but especially after being excluded. As evidenced by the schema domains, the study found a connection between impaired limits-schema domain and the drive to binge.ConclusionThe results show how, after bariatric surgery, obese patients cannot differentiate between social inclusion and exclusion and are detached from social interactions. This cognitive style could be reinforced by particular early-maladaptive schemas that could be considered specific therapeutic targets for improving specific interpersonal skills in future research.Level of evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.