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Loss of control eating and weight outcomes after bariatric surgery: a study with a Portuguese sample

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Abstract

The present study aim is to investigate the frequency of loss of control eating (LOC) episodes in three groups with different assessment times: one before, one at short and one at long-term after bariatric surgery; as well as to explore the association of postoperative problematic eating behaviors and weight outcomes and psychological characteristics. This cross-sectional study compared a group of preoperative bariatric surgery patients (n = 176) and two postoperative groups, one at short-term with <2 years follow-up (n = 110), and one at long-term >2 years follow-up (n = 53). Assessments included the EDE diagnostic interview and a set of self-report measures assessing eating disordered symptomatology, depression, and body image. We found the presence of LOC in 26.7 and 16.9 % of the pre-operative and long-term patients, respectively, and in about 11.8 % of the short-term patients. One patient (0.9 %) reported objective binge eating episodes at short-time, but subjective binge eating episodes were present in about 10 % of the patients in all groups. LOC eating was related with the highest BMIs, the least weight loss, most weight regain, and most psychological impairment in the long-term assessments, but not at short-term. Despite the lower frequencies of disordered eating behavior in the short-term group, patients reporting LOC seem to represent a subgroup of individuals with poorest outcomes after surgery and most psychological distress.

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References

  1. Kofman MD, Lent MR, Swencionis C (2010) Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity 18:1938–1943

    Article  PubMed  Google Scholar 

  2. Beck NN, Mehlsen M, René KS, Alverdy C, le Grange D (2012) Psychological characteristics and associations with weight outcomes two years after gastric bypass surgery: postoperative eating disorder symptoms are associated with weight loss outcomes. Eat Behav 13(4):394–397

    Article  PubMed  Google Scholar 

  3. Sarwer DB, Dilks RJ, West-Smith L (2011) Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Rel Dis 7(5):644–651

    Article  Google Scholar 

  4. Saunders R (2004) “Grazing”: a high-risk behavior. Obes Surg 14:98–102

    Article  PubMed  Google Scholar 

  5. van Hout GC, Verschure SKM, van Heck GL (2005) Psychosocial predictors of success following bariatric surgery. Obes Surg 15:552–560

    Article  PubMed  Google Scholar 

  6. Poole NA, Atar AA, Kuhanendran D, Bidlake L, Fiennes A, McCluskey S et al (2005) Compliance with surgical after-care following bariatric surgery for morbid obesity: a retrospective study. Obes Surg 15:261–265

    Article  PubMed  Google Scholar 

  7. Niego SH, Kofman MD, Weiss JJ, Geliebter A (2007) Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Dis 40:349–359

    Article  Google Scholar 

  8. White MA, Kalarchian MA, Masheb RM, Marcus MD, Grilo CM (2010) Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psych 71(2):175–184

    Article  Google Scholar 

  9. Colles SL, Dixon JB, O’Brien PE (2008) Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity 16:615–622

    Article  PubMed  Google Scholar 

  10. de Zwaan M, Hilbert A, Swan-Kremeier L, Simonich H, Lancaster K, Howell LM et al (2010) Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Rel Dis 6(1):79–85

    Article  Google Scholar 

  11. Hsu LKG, Mulliken B, McDonagh B, Krupa Das S, Rand W, Fairburn CG et al (2002) Binge eating disorder in extreme obesity. Int J Obes 26:1398–1403

    Article  CAS  Google Scholar 

  12. Kalarchian MA, Wilson GT, Brolin RE, Bradley L (1998) Binge eating in bariatric surgery patients. Int J Eat Dis 23:89–92

    Article  CAS  Google Scholar 

  13. Hsu LKG, Sullivan SP, Benotti PN (1997) Eating disturbances and outcome of gastric bypass surgery: a pilot study. Int J Eat Dis 21:385–390

    Article  CAS  Google Scholar 

  14. Larsen JK, van Ramshorst B, Geenen R, Brand N, Stroebe W, van Doornen LJP (2004) Binge eating and its relationship to outcome after laparoscopic adjustable gastric banding. Obes Surg 14:1111–1117

    Article  PubMed  Google Scholar 

  15. Latner J, Wetzler S, Goodman ER, Glinski J (2004) Gastric bypass in a low-income, inner-city population: eating disturbances and weight loss. Obes Res 12(6):956–961

    Article  PubMed  Google Scholar 

  16. van Hout G, Jakimowicz JJ, Fortuin F, Pelle A, van Heck G (2007) Weight loss and eating behavior following vertical banded gastroplasty. Obes Surg 17(9):1226–1234

    Article  PubMed Central  PubMed  Google Scholar 

  17. Carter FA, Jansen A (2012) Improving psychological treatment for obesity. Which eating behaviours should we target? Appetite 58:1063–1069

    Article  PubMed  Google Scholar 

  18. Kalarchian M, Wilson GT, Brolin RE, Bradley L (1999) Effects of bariatric surgery on binge eating and related psychopathology. Eat Weight Disord 4:1–5

    CAS  PubMed  Google Scholar 

  19. Pekkarinen T, Koskela K, Huikuri K, Mustajoki P (1994) Long-term results of gastroplasty for morbid obesity: binge-eating as a predictor of poor outcome. Obes Surg 4:248–255

    Article  PubMed  Google Scholar 

  20. Bocchieri LE, Meana M, Fisher BL (2002) A review of psychosocial outcomes of surgery for morbid obesity. J Psych Res 52:155–165

    Article  Google Scholar 

  21. Burgmer R, Petersen I, Burgmer M, de Zwaan M, Wolf AM, Herpertz S (2007) Psychological outcome two years after restrictive bariatric surgery. Obes Surg 17:785–791

    Article  PubMed  Google Scholar 

  22. Sallet PC, Sallet JA, Dixon JB, Collis E, Pisani CE, Levy A et al (2007) Eating behavior as a prognostic factor for weight loss after gastric bypass. Obes Surg 17:445–451

    Article  PubMed  Google Scholar 

  23. Hsu L, Benotti PN, Dwyer J, Roberts SB, Saltzman E, Shikora S et al (1998) Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychos Med 60:338–346

    CAS  Google Scholar 

  24. Alger-Mayer S, Rosati C, Polimeni J, Malone M (2009) Preoperative binge eating status and gastric bypass surgery: a long-term outcome study. Obe Surg 19(2):139–145

    Article  CAS  Google Scholar 

  25. Lang T, Hauser R, Buddeberg C, Klaghofer R (2002) Impact of gastric banding on eating behavior and weight. Obes Surg 12(1):100–107

    Article  PubMed  Google Scholar 

  26. Guisado Macias J, Vaz Leal F (2003) Psychopathological differences between morbidly obese binge eaters and non-binge eaters after bariatric surgery. Eat Weight Disord 8:315–318

    Article  CAS  PubMed  Google Scholar 

  27. Fairburn C, Cooper Z, O’Connor M (2008) Eating disorder examination (Edition 16.0D). In: Fairburn C (ed) Cognitive behavior therapy and eating disorders. Guilford Press, New York

  28. APA (2012) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, USA. Retrieved May, 2012, from http://www.dsm5.org/

  29. Machado PP, Machado B, Gonçalves S, Hoek H (2007) The prevalence of eating disorders not otherwise specified. Int J Eat Dis 40:212–217

    Article  Google Scholar 

  30. Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Dis 16(4):363–370

    CAS  Google Scholar 

  31. Cooper PJ, Taylor MJ, Cooper Z, Fairbun CG (1987) The development and validation of the body shape questionnaire. Int J Eat Dis 6(4):485–494

    Article  Google Scholar 

  32. Teixeira P, Silva MN, Coutinho SR et al (2010) Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity 18(4):725–735

    Article  PubMed  Google Scholar 

  33. Beck A, Steer R, Garbin M (1988) Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psych Rev 8:77–100

    Article  Google Scholar 

  34. Hayden MJ, Dixon JB, Dixon ME, O’Brien PE (2010) Confirmatory factor analysis of the beck depression inventory in obese individuals seeking surgery. Obes Surg 20:432–439

    Article  PubMed  Google Scholar 

  35. Vaz Serra A, Pio Abreu JL (1973) Aferição dos quadros clínicos depressivos. I—Ensaio de aplicação do “Inventário Depressivo de Beck” a uma amostra portuguesa de doentes deprimidos. Coimbra Médica, XX, 623–644

  36. Deitel M, Gawdat K, Melissas J (2007) Reporting weight loss. Obes Surg 17:565–568

    Article  PubMed  Google Scholar 

  37. de Zwaan M (2001) Binge eating disorder and obesity. Int J Obes 25:s51–s55

    Article  Google Scholar 

  38. Pratt E, Niego S, Agras S (1998) Does the size of a binge matter? Int J Eat Dis 24(3):307–312

    Article  CAS  Google Scholar 

  39. Niego S, Pratt E, Agras S (1997) Subjective or objective binge: is the distinction valid? Int J Eat Dis 22:291–298

    Article  CAS  Google Scholar 

  40. Dixon J, Dixon M, O’Brien P (2001) Pre-operative predictors of weight loss at 1-year after Lap-Band® surgery. Obes Surg 2(11):200–207

    Article  Google Scholar 

  41. Hutter M, Schirmer B, Jones D, Ko C, Cohen M, Merkow R et al (2011) First report from the American College of Surgeons—Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 254(3):410–422

    Article  PubMed Central  PubMed  Google Scholar 

  42. Pessina A, Andreoli M, Vassallo C (2001) Adaptability and compliance of the obese patient to restrictive gastric surgery in the short term. Obes Surg 11:459–463

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank Dr. James E. Mitchell for his kind suggestions on a preliminary version of this work. We thank the study participants for their contribution in time and effort in support of this study. This research was partially supported by a Fundação para a Ciência e a Tecnologia/Foundation for Science and Technology, Portugal (SFRH/BPD/78896/2011) grant to Eva Conceição; grant (PTDC/PSIPCL/099981/2008) to Paulo Machado; and (SFRH/BD/44293/2008) grant to Ana Vaz. FCT had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal

    Eva Conceição, Ana Pinto Bastos, Ana Rita Vaz, Sofia Ramalho & Paulo P. P. Machado

  2. Faculty of Medicine, Hospital de São João, Alameda Prof. Hernâni Monteiro, University of Porto, 4200-319, Porto, Portugal

    Isabel Brandão & Filipa Arrojado

  3. Hospital de Braga, Sete Fontes, São Victor, 4710-243, Braga, Portugal

    José Maia da Costa

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  1. Eva Conceição
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  2. Ana Pinto Bastos
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  8. Paulo P. P. Machado
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Correspondence to Eva Conceição.

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Conceição, E., Bastos, A.P., Brandão, I. et al. Loss of control eating and weight outcomes after bariatric surgery: a study with a Portuguese sample. Eat Weight Disord 19, 103–109 (2014). https://doi.org/10.1007/s40519-013-0069-0

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  • DOI: https://doi.org/10.1007/s40519-013-0069-0

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