Article

Loss of Control Over Eating Predicts Outcomes in Bariatric Surgery Patients: A Prospective, 24-Month Follow-Up Study

Department of Psychiatry, Yale University School of Medicine, PO Box 208098, New Haven, CT 06520, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 10/2009; 71(2):175-84. DOI: 10.4088/JCP.08m04328blu
Source: PubMed

ABSTRACT This study examined the clinical significance of loss of control (LOC) over eating in bariatric surgery patients over 24 months of prospective, multiwave follow-ups.
Three hundred sixty-one gastric bypass surgery patients completed a battery of assessments before surgery and at 6, 12, and 24 months following surgery. In addition to weight loss and LOC over eating, the assessments targeted eating disorder psychopathology, depression levels, and quality of life. The study was conducted between January 2002 and February 2008.
Prior to surgery, 61% of patients reported general LOC; postsurgery, 31% reported LOC at 6-month follow-up, 36% reported LOC at 12-month follow-up, and 39% reported LOC at 24-month follow-up. Preoperative LOC did not predict postoperative outcomes. In contrast, mixed models analyses revealed that postsurgery LOC was predictive of weight loss outcomes: patients with LOC postsurgery lost significantly less weight at 12-month (34.6% vs 37.2% BMI loss) and 24-month (35.8% vs 39.1% BMI loss) postsurgery follow-ups. Postsurgery LOC also significantly predicted eating disorder psychopathology, depression, and quality of life at 12- and 24-month postsurgery follow-ups.
Preoperative LOC does not appear to be a negative prognostic indicator for postsurgical outcomes. Postoperative LOC, however, significantly predicts poorer postsurgical weight loss and psychosocial outcomes at 12 and 24 months following surgery. Since LOC following bariatric surgery significantly predicts attenuated postsurgical improvements, it may signal a need for clinical attention.

Full-text

Available from: Marney A White, Jun 02, 2015
0 Followers
 · 
103 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Initial evidence that cognitive function improves after bariatric surgery exists. The post-surgery increase in cognitive control might correspond with a decrease of impulsive symptoms after surgery. The present study investigated cognitive function and nonfood-related impulsivity in patients with substantial weight loss due to bariatric surgery by using a comparative cross-sectional design. Fifty post-bariatric surgery patients (postBS group) who had significant percent weight loss (M = 75.94, SD = 18.09) after Roux-en-Y gastric bypass (body mass index, BMI M post = 30.54 kg/m(2), SDpost = 5.14) were compared with 50 age and gender matched bariatric surgery candidates (preBS group; BMI M pre = 48.01 kg/m(2), SDpre = 6.56). To measure cognitive function the following computer-assisted behavioral tasks were utilized: Iowa Gambling Task, Tower of Hanoi, Stroop Test, Trail Making Test-Part B, and Corsi Block Tapping Test. Impulsive symptoms and behaviors were assessed using impulsivity questionnaires and a structured interview for impulse control disorders (ICDs). No group differences were found with regard to performance-based cognitive control, self-reported impulsive symptoms, and ICDs. The results indicate that the general tendency to react impulsively does not differ between pre-surgery and post-surgery patients. The question of whether nonfood-related impulsivity in morbidly obese patients changes post-surgery should be addressed in longitudinal studies given that impulsive symptoms can be considered potential targets for pre- as well post-surgery interventions.
    Frontiers in Psychology 12/2014; 5:1502. DOI:10.3389/fpsyg.2014.01502 · 2.80 Impact Factor
  • 12/2014; 1(1). DOI:10.1186/s40608-014-0020-6
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the factor structure and psychometric properties of the TFEQ in a morbid obese Spanish sample of bariatric surgery candidates. Multi-trait/ multi-item analyses and alpha coefficients were conducted to test the convergent /discriminant validity and the internal consistency reliability. Principal components analyses (varimax) were used to explore the factor structure. Sub-group factor analyses by gender, age and body mass index (BMI) were conducted to identify unstable items. The internal structure of the original TFEQ factors was unsatisfactory, especially the Disinhibition Scale. Most Disinhibition and Hunger items were grouped on one factor labeled “Dysregulation Eating”. Cognitive Restraint was split into two factors. The first one, related to the behavioral component of Restraint, labeled “Restrained Behaviour” and the second one related to weight and eating concerns called “Predisposition to Restraint”. The original factor structure of the TFEQ was not replicated. A revised 23-item instrument, representing the three new derived factors is offered as a valid screening instrument for severely obese patients.
    Psicothema 04/2015; 27(2). DOI:10.7334/psicothema2014.46 · 0.96 Impact Factor