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Int J Eat Disord. 2016 Dec;49(12):1058-1067. doi: 10.1002/eat.22578. Epub 2016 Jul 18.

Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.

Author information

1
Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York.
2
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Penninsylvania.
3
School of Nursing, Duquesne University, Pittsburgh, Penninsylvania.
4
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Penninsylvania.
5
Sanford Health System, Fargo, North Dakota.
6
Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
7
Neuropsychiatric Research Institute, Fargo, North Dakota.

Abstract

OBJECTIVE:

Bariatric surgery results in significant long-term weight loss, albeit with considerable variability. This study examines the prognostic significance of eating pathology as determined by a structured interview, the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV).

METHOD:

Participants (N = 183) in this substudy of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium were assessed using the EDE-BSV, independent of clinical care, presurgery and annually postsurgery. We examined eating pathology and experiences at several frequency thresholds (present, ≥ monthly, ≥ weekly) over 3 years, and utilized mixed models to test their associations with percentage weight loss from baseline at years 1, 2, and 3.

RESULTS:

The prevalence of several forms of eating pathology declined pre- to 1-year postsurgery, including ≥weekly objective bulimic episodes (11.6-1.3%), loss of control (LOC) eating (18.3-6.2%) and picking/nibbling (36.0-20.2%) (P for all <0.01), and regular evening hyperphagia (16.5-5.0%, P = 0.01), but not cravings (P = 0.93). Mean EDE global score, and hunger and enjoyment scores, also declined (P for all <0.01). These metrics remained lower than baseline through year-3 (P for all <0.01). Presurgery eating variables were not related to weight loss (P for all ≥0.05). However, postsurgery higher EDE global score and greater hunger were independently associated with less weight loss postsurgery (P for both ≤0.01), while cravings were associated with greater weight loss (P = 0.03).

DISCUSSION:

Pathological eating behaviors and experiences are common presurgery and improve markedly following surgery. Postsurgery pathological eating-related experiences and attitudes and hunger may contribute to suboptimal weight loss. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1058-1067).

KEYWORDS:

bariatric surgery; binge eating; disordered eating; hunger; loss of control eating

PMID:
27425771
PMCID:
PMC5161707
DOI:
10.1002/eat.22578
[Indexed for MEDLINE]
Free PMC Article

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