Loss of Control Eating and Binge Eating in the 7 Years Following Bariatric Surgery

Background Although bariatric surgery is an effective intervention for severe obesity, a subset of patients demonstrates suboptimal weight outcomes. Postoperative loss of control eating (LOCE) and binge eating may influence weight outcomes, though research has not examined differences by surgical pr...

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Bibliographic Details
Published in:Obesity surgery 2019-06, Vol.29 (6), p.1773-1780
Main Authors: Smith, Kathryn E., Orcutt, Molly, Steffen, Kristine J., Crosby, Ross D., Cao, Li, Garcia, Luis, Mitchell, James E.
Format: Article
Language:English
Subjects:
Bariatric Surgery
Binge eating
Bulimia - etiology
Female
Gastrointestinal surgery
Humans
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Middle Aged
North Dakota
Obesity, Morbid - surgery
Original Contributions
Postoperative Period
Prospective Studies
Surgery
Weight Loss
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Summary:Background Although bariatric surgery is an effective intervention for severe obesity, a subset of patients demonstrates suboptimal weight outcomes. Postoperative loss of control eating (LOCE) and binge eating may influence weight outcomes, though research has not examined differences by surgical procedure, or factors that predict postoperative LOCE. This study aimed to [1] characterize LOCE and binge eating disorder (BED) over a 7-year period following bariatric surgery; [2] examine concurrent, prospective, and cumulative relationships between LOCE and weight loss; [3] assess whether these associations are moderated by surgery type; and [4] evaluate predictors of LOCE. Methods Participants were 2156 patients who underwent laparoscopic adjustable gastric banding (LAGB) or Roux-n-Y gastric bypass (RYGB) in the multi-center Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Generalized linear mixed models examined relationships between LOCE and percent weight loss and predictors of LOCE. Results LOCE and BED initially declined then increased after surgery, with a notable number of de-novo cases (25.6% and 4.8%, respectively). LOCE was related to less concurrent but not prospective or cumulative percent weight loss. Self-monitoring of eating, higher daily eating frequency, older age, male gender, and higher self-esteem were associated with a lower likelihood of LOCE. Conclusions Results suggest that LOCE and binge eating are clinically relevant behaviors that may impede weight loss, and findings highlight the importance of ongoing assessment of maladaptive eating following surgery.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-019-03791-x