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Surg Obes Relat Dis. 2015 May-Jun;11(3):621-6. doi: 10.1016/j.soard.2014.09.018. Epub 2014 Nov 28.

Nonnormative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome.

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Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany. Electronic address:
Department of General Surgery, Asklepios Clinic, Hamburg, Germany.
Schön Klinik Hamburg Eilbek Bariatric Clinic, Hamburg, Germany.
Department of General, Visceral, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany.
Department of Visceral, Pediatric, and Vascular Surgery, Hospital Konstanz, Konstanz, Germany.
Department of General, Abdominal and Pediatric Surgery, SRH Municipal Hospital, Gera, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.
Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Leipzig, Germany.



Binge-eating disorder (BED) as a distinct eating disorder category and night eating syndrome (NES) as a form of Other Specified Feeding or Eating Disorders were recently included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study sought to investigate the prevalence of BED and NES and associations with various forms of nonnormative eating behavior and psychopathology in prebariatric patients. Within a consecutive multicenter registry study, patients in 6 bariatric surgery centers in Germany were recruited.


Overall, 233 prebariatric patients were assessed using the Eating Disorder Examination and self-report questionnaires. Assessment was unrelated to clinical procedures.


Diagnostic criteria for full-syndrome BED and NES were currently met by 4.3% and 8.2% of prebariatric patients, respectively. In addition, 8.6% and 6.9% of patients met subsyndromal BED and NES criteria, respectively. Co-morbid BED and NES diagnoses were present in 3.9% of patients. In comparison to patients without any eating disorder symptoms, patients with BED and NES reported greater emotional eating, eating in the absence of hunger, and more symptoms of food addiction. Moreover, differences between patients with BED and NES emerged with more objective binge-eating episodes and higher levels of eating concern, weight concern, and global eating disorder psychopathology in patients with BED.


BED and NES were shown to be prevalent among prebariatric patients, with some degree of overlap between diagnoses. Associations with nonnormative eating behavior and psychopathology point to their clinical significance and discriminant validity.


Binge-eating disorder; Eating disorders; Night eating syndrome; Nonnormative eating behavior

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