Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study.

Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Obesity (Impact Factor: 4.39). 01/2011; 19(6):1220-8. DOI: 10.1038/oby.2010.336
Source: PubMed

ABSTRACT Previous studies have suggested that binge eating disorder (BED) impairs weight loss following bariatric surgery, leading some investigators to recommend that patients receive behavioral treatment for this condition before surgery. However, many of these investigations had significant methodological limitations. The present observational study used a modified intention-to-treat (ITT) population to compare 1-year changes in weight in 59 surgically treated participants, determined preoperatively to be free of a current eating disorder, with changes in 36 individuals judged to have BED. Changes in weight and binge eating in the latter group were compared with those in 49 obese individuals with BED who sought lifestyle modification for weight loss. BED was assessed using criteria proposed for the Diagnostic and Statistical Manual (DSM) 5. At 1 year, surgically treated participants without BED lost 24.2% of initial weight, compared with 22.1% for those with BED (P > 0.309). Both groups achieved clinically significant improvements in several cardiovascular disease (CVD) risk factors. Participants with BED who received lifestyle modification lost 10.3% at 1 year, significantly (P < 0.001) less than surgically treated BED participants. The mean number of binge eating days (in the prior 28 days) fell sharply in both BED groups at 1 year. These two groups did not differ significantly in BED remission rates or in improvements in CVD risk factors. The present results, obtained in carefully studied participants, indicate that the preoperative presence of BED does not attenuate weight loss or improvements in CVD risk factors at 1 year in surgically treated patients. Longer follow-up of participants is required.

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    ABSTRACT: Background Maladaptive eating behaviors after bariatric surgery are thought to compromise weight outcomes, but little is known about their frequency over time. Objective This study investigates the presence of subjective binge eating (SBE), objective binge eating (OBE) and picking and nibbling (P&N) before surgery and at different time periods postoperative, and their association with weight outcomes. Methods This cross-sectional study assessed a group of patients before surgery (n = 61), and three post-operative groups: 1) 90 patients (27 with laparoscopic adjustable gastric band (LAGB) and 63 with Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)) assessed during their 6 month follow-up medical appointment; 2) 96 patients (34 LAGB and 62 LRYGB) assessed during their one year follow-up medical appointment; and 3) 127 patients (62 LAGB and 55 LRYGB) assessed during their second year follow-up medical appointment. Assessment included the Eating Disorders Examination and a set of self-report measures. Results In the first ten months after surgery fewer participants reported maladaptive eating behaviors. No OBEs were reported at 6 months. SBE episodes were present in all groups. P&N was the most frequently reported eating behavior. Eating behavior (P&N) was significantly associated with weight regain, and non-behavioral variables were associated with weight loss. Conclusions This study is cross-sectional study which greatly limits the interpretation of outcomes and no causal association can be made. However, a subgroup of postoperative patients report eating behaviors that are associated with greater weight regain. The early detection of these eating behaviors might be important in the prevention of problematic outcomes after bariatric surgery.
    Eating Behaviors 12/2014; 15(4). DOI:10.1016/j.eatbeh.2014.08.010 · 1.58 Impact Factor
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    ABSTRACT: Health experts advise and expect patients to eat healthily after bariatric surgery. For patients, difficulties with eating might have been a long-standing, problematic part of life-a part that is not necessarily healed by surgery. Empirical research on patients' experiences of eating practices after bariatric surgery is lacking. Aiming to contribute to the development of clinical practice, we explored meanings attached to eating in the long term and sought descriptions of change and bodily sensations. We interviewed 14 patients at least 5 years after bariatric surgery. The surgical restriction forced changes in the way patients sensed their own body in eating, but the uncertainty related to maintaining weight loss in the long term remained. Meanings attached to eating transcended food as choices situated in a nourishment and health perspective, and were not necessarily changed. Eating was an existential and embodied practice, which remained an ambiguous and sensitive matter after surgery.
    Qualitative Health Research 08/2014; 24(12). DOI:10.1177/1049732314548687 · 2.19 Impact Factor
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    ABSTRACT: New diagnostic criteria for Binge Eating Disorder (BED) are less restrictive•We compared psychopathology of severe obese patients and of BED patients.•We diagnosed BED patients following the DSM IV TR criteria•We diagnosed BED patients following the DSM5 criteria•The levels of psychopathology of the two categories of BED are very similar•BED patients have higher levels of psychopathology than other severe obese patients
    Eating Behaviors 11/2014; DOI:10.1016/j.eatbeh.2014.10.004 · 1.58 Impact Factor

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