Aspiring personality: Patients waiting for obesity treatment Danilo Garcia , 1,2,3 Henrik Forssell, 1,4 and Kevin M. Cloninger 1,5 Abstract: The aim of the present study was to investigate differences in temperament and character between patients (N = 70) waiting for obesity surgery and the general population. Patients waiting for obesity surgery scored higher in Harm-Avoidance, Reward Depen- dence, Persistence, and Cooperativeness and also lower in Self-Directedness. Keywords: aspire therapy; character; obesity; personality; temperament Whereas successful long-term weight loss among people suf- fering from obesity can be achieved through a combination of psychological intervention, exercise, and dietary strategies, surgery is suggested as the most effective treatment available today (Norén & Forsell, 2016). For instance, patients treated with aspire therapy (an endoscopically placed gastrostomy tube allowing patients to aspirate gastric contents 20 min after meal consumption) had an excess weight loss of 54.4% and a significant increase in quality of life 1 year after surgery (Norén & Forsell, 2016). Nevertheless, obesity is more likely to be understood as a spectrum syndrome (a disorder including a range of linked conditions). Maladaptive behavior or destructive coping strategies (physical inactivity, smoking, and drinking), for example, alter bodily functions, which in turn lead to obesity and cardiovascular or other diseases (Cooper, 2013). Besides genetic factors, this type of maladaptive behav- ior is related to an inability to make healthy self-directed choices. Indeed, individual differences in personality, lifestyle, and stress account for much of the mortality from physical dis- orders (Mokdad, Marks, Stroup, & Gerberding, 2004). Never- theless, results are inconsistent regarding the relationship between obesity and personality traits. Some researchers even suggest that obese individuals do not differ in personality from the general population. But this inconsistency might depend on limitations in the measures used for most research, which are designed to evaluate abnormal personality, rather than vari- ations in normal personality, or are not designed to assess per- sonality holistically (cf. Sullivan, Cloninger, Przybeck, & Klein, 2007). In contrast, Cloninger’ s (2004) biopsychosocial model organizes personality into two domains: temperament and character. Temperament is composed of novelty seeking (the degree to which a person seeks out new experiences, despite possible consequences), harm avoidance (the degree to which a person restrains their urges, drives, and impulses), reward dependence (the degree to which a person is sensitive to or dependent on the responses and/or approval of others), and persistence (the degree to which a person perseveres in the face of obstacles). Temperament thus represents the bio- logical aspect of personality and is useful for predicting the type of disorders, but insufficient for predicting who will develop disorders or maladaptive behaviors (Cloninger, 2004). While temperament includes aspects of emotional responses that are stable through time, character represents mental self- government, humanistic values, and social aspects, or what one makes of oneself intentionally, and develops with time: self-directedness (being able to control, regulate, and adapt behavior in accordance to one’ s own goals and values, being self-sufficient, self-acceptant, responsible, reliable, and effec- tive), cooperativeness (the degree to which one identifies with, supports, and accepts others’ as well as one’ s own needs), and self-transcendence (self-forgetfulness, patience, spirituality, and identification with something bigger than the self that gives meaning to one’ s existence). Hence, character indicates how one regulates the different emotional reactions and behav- iors generated from one’ s own temperament. This study aimed to investigate differences in personality between patients waiting for obesity surgery (aspire ther- apy) and the general population. We compared 70 Swedish patients to normative data (N = 1,230) from the Swedish population (Fahlgren, Nima, Archer, & Garcia, 2015). All completed the Temperament and Character Inventory– Revised, which measures Cloninger’ s biopsychosocial 1 Blekinge Center of Competence, Blekinge County Council, Karlskrona, Sweden, 2 Department of Psychology, University of Gothen- burg, Gothenburg, Sweden, 3 Network for Empowerment and Well-Being, Sweden, 4 Department of Surgery, Blekinge County Hospital, Karlskrona, Sweden, 5 Anthropedia Foundation, St. Louis, Missouri, USA Correspondence to: Associate Professor Danilo Garcia, Blekinge County Council, Blekinge Center of Competence, Vårdskolevägen 5, SE 371 41 Karlskrona, Sweden. Email: danilo.garcia@icloud.com Received 3 July 2017. Accepted 6 February 2018. © 2018 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd PsyCh Journal (2018) DOI: 10.1002/pchj.209