Binge Eating and its Relationship to Outcome after Laparoscopic Adjustable Gastric Banding

Utrecht University, Utrecht, Utrecht, Netherlands
Obesity Surgery (Impact Factor: 3.75). 10/2004; 14(8):1111-7. DOI: 10.1381/0960892041975587
Source: PubMed


The aim of this cross-sectional study was to examine short and long-term eating behavior after laparoscopic adjustable gastric banding (LAGB) and the relationship of binge eating with weight and quality of life outcome.
250 patients (221 female, 29 male, mean age 39.6 years, age range 22-61) filled out questionnaires to evaluate quality of life and eating behavior: 93 patients before LAGB, 48 with a follow-up duration of 8 through 24 months, and 109 patients 25 through 68 months after LAGB.
Compared with patients before surgery, patients after surgery, in both follow-up groups, reported less binge eating, fat intake, external eating, and more restrained eating and eating self-efficacy. After surgery, about one-third of the patients showed binge eating problems, which were associated with a worse postoperative outcome.
Our results suggest that eating behavior improves both short- and long-term after surgery for severe obesity. Although LAGB could be a long-term solution to part of preoperatively eating disordered patients, the identification and treatment of postoperative binge eating appear critical to promote successful outcome after bariatric surgery.

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    • "The findings from the three studies discussed above [27, 31, 32] suggest that emotional eaters might use food to feel better in reaction to a host of negative feelings and associated situations including distress about loss-of-control eating. Further research, however, might find that some bariatric patients only use food to alleviate distress triggered by their inability to exercise dietary restraint. "
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    ABSTRACT: Empirical investigations implicate emotional eating (EE) in dysfunctional eating behavior such as uncontrolled overeating and insufficient weight loss following bariatric surgery. They demonstrate that EE may be a conscious or reflexive behavior motivated by multiple negative emotions and/or feelings of distress about loss-of-control eating. EE, however, has not been targeted in pre- or postoperative interventions or examined as an explanatory construct for failed treatment of dysfunctional eating. Three cases suggest that cognitive behavioral treatment (CBT) might alleviate EE. One describes treatment for distress provoked by loss-of-control eating. The first of two others, associated with negative emotions/life situations, link treatment of a super-super-preoperative obese individual's reflexive EE with 52% excess BMI (body mass index) loss maintained for the past year, 64 months after surgery. The second relates treatment of conscious/reflexive EE with 84.52% excess BMI loss 53 months after surgery. Implications for research and treatment are discussed.
    Full-text · Article · Apr 2012 · The Scientific World Journal
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    • "Duration of follow-up was associated with lower WEL after adjusting for other factors; however, our primary predictor of overall WEL score (% weight loss) lost significance in patients with the greatest duration of follow-up time after stratification. Previous studies have demonstrated that self-efficacy after weight loss is preserved in the short and intermediate term but may be compromised in long-term, making weight strategies often unsuccessful in obese patients (Larsen et al., 2004); this observation may not be much different in bariatric surgery patients. Prospective collection of self-efficacy scores are needed to overcome this limitation to ascertain the true impact of time after surgical intervention on self-efficacy scores. "
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    ABSTRACT: Eating behaviors often predict outcomes after bariatric surgery, and in this regard, self-efficacy has been shown to predict long-term behavior. We examined current eating self-efficacy in post-bariatric surgery patients comparing them to obese non-surgery patients to determine whether weight loss is associated with increased self-efficacy in post-bariatric surgery patients. We performed a population-based study of patients evaluated for Roux-en-Y gastric bypass and administered a survey using the Weight Efficacy Lifestyle (WEL) Questionnaire. There were 148 surgical and 88 non-operative patients who responded. Overall WEL score was assessed using linear regression models. Predictors of an increased self-efficacy score were also examined. Follow-up was 4.0 and 3.8 years in the operative and non-operative groups, respectively. Operative responders were slightly older and had a lesser BMI compared to non-responders, otherwise the demographics were similar. Difference in overall WEL between groups was 25.5+/-5.3 points on a 0-180 scale. A 25% change in weight was associated with a difference of 15.4 points on the total WEL between groups. Current self-efficacy scores were highly related to weight loss and correlated to quality of life at follow-up (rho=0.36). Profound weight loss after bariatric surgery is associated with increased eating self-efficacy in a population of obese adults seeking medical treatment for obesity.
    Full-text · Article · Jul 2009 · Appetite
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    • "Unsuccessful weight loss was defined as a BMI 40 and less than 10 BMI points weight loss at the time of the interview and 2 years after the operation when transition from weight loss to weight maintenance had occurred [19] [20]. Of the 24 LAGB patients who fulfilled these criteria (22%), 6 already had gastric bypass surgery and were excluded, leaving 18 evaluable patients of whom 12 were randomly selected and invited to participate. "
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    ABSTRACT: Not all morbidly obese patients attain sufficient weight loss after laparoscopic adjustable gastric banding (LAGB). We examined patients' explanations for unsuccessful weight loss and self-awareness regarding food intake. Interviews with 11 patients (10 female/1 male; mean age 46 years) with unsuccessful weight loss were transcribed and analyzed with the MAXqda2 program. Interviewees were disappointed with the postoperative outcome. Some showed no awareness of their own role, while others were inefficacious to continue the actions needed to maintain weight loss, especially during times of stress. Typical statements that distinguished interviewees were: 'It didn't work out', 'I don't care anymore', 'I know I have to do it', 'I know I can do it'. Some patients with unsuccessful weight loss after LAGB are insufficiently aware that their own effort is needed to maintain weight loss. Others have self-awareness, but find it difficult to turn awareness into action. This group could perhaps be helped by tailoring postoperative guidance to the stage of change of an individual patient. Counseling could include increasing awareness of the need to self-control eating and offering assistance to turn intentions into action and to deal with stress, emotions and physical problems.
    Full-text · Article · Dec 2008 · Patient Education and Counseling
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