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Table 2 Examples of feedback messages for different patterns of change used in the algorithm for the feedback message system

From: APOLO-Bari, an internet-based program for longitudinal support of bariatric surgery patients: study protocol for a randomized controlled trial

Grazing

Binge eating

Overeating

Feedback message

n

n

d

Be aware! Your eating is becoming disorganized. Try to understand what is happening – that is the only way you can get back on track. Do not give up on yourself!

n

p

p

To reduce grazing, do not skip meals, and take time to sit down while you are eating. You’ll see the benefits soon!

i

i

n

We have noticed that you have reduced the frequency of some maladaptive eating behaviors. Try to focus your attention on overeating episodes. Do not keep leftovers, and limit the amount of food you have at home, especially those foods that make you feel out of control. You have every reason to keep investing in yourself.

d

d

p

People often eat in a compulsive way to cope with strong emotions, particularly when they are sad, hungry, or anxious. It is important to anticipate a list of alternative activities to distract yourself from eating in those situations. You may want to avoid going to the grocery store to limit the amount of food available.

p

n

p

Be aware of when binge eating episodes occur. Awareness allows the anticipation of difficult situations and the identification of triggers for these episodes. It also helps to understand the role of these episodes in your life (e.g., eating compulsively to cope with certain feelings or emotions, eating at the end of the day when feeling lonely or when you have a day off work). You can then find alternative strategies to anticipate such difficult situations. Go for it!

p

p

p

We are happy that you have been able to keep a regular and adjusted eating pattern. Enjoy the possibility of having a healthy life, and you will have no problem maintaining a healthy weight.

  1. n negative (symptomatic), p positive (non-symptomatic), i improved (from symptomatic to non-symptomatic), d deteriorated (from non-symptomatic to symptomatic)