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Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.

ABSTRACT: OBJECTIVE:Bariatric surgery results in significant long-term weight loss, albeit with considerable variability. This study examines the prognostic significance of eating pathology as determined by a structured interview, the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV). METHOD:Participants (N = 183) in this substudy of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium were assessed using the EDE-BSV, independent of clinical care, presurgery and annually postsurgery. We examined eating pathology and experiences at several frequency thresholds (present,???monthly,???weekly) over 3 years, and utilized mixed models to test their associations with percentage weight loss from baseline at years 1, 2, and 3. RESULTS:The prevalence of several forms of eating pathology declined pre- to 1-year postsurgery, including ?weekly objective bulimic episodes (11.6-1.3%), loss of control (LOC) eating (18.3-6.2%) and picking/nibbling (36.0-20.2%) (P for all <0.01), and regular evening hyperphagia (16.5-5.0%, P = 0.01), but not cravings (P = 0.93). Mean EDE global score, and hunger and enjoyment scores, also declined (P for all <0.01). These metrics remained lower than baseline through year-3 (P for all <0.01). Presurgery eating variables were not related to weight loss (P for all ?0.05). However, postsurgery higher EDE global score and greater hunger were independently associated with less weight loss postsurgery (P for both ?0.01), while cravings were associated with greater weight loss (P = 0.03). DISCUSSION:Pathological eating behaviors and experiences are common presurgery and improve markedly following surgery. Postsurgery pathological eating-related experiences and attitudes and hunger may contribute to suboptimal weight loss. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1058-1067).

SUBMITTER: Devlin MJ

PROVIDER: S-EPMC5161707 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.

Devlin Michael J MJ King Wendy C WC Kalarchian Melissa A MA White Gretchen E GE Marcus Marsha D MD Garcia Luis L Yanovski Susan Z SZ Mitchell James E JE

The International journal of eating disorders 20160718 12

<h4>Objective</h4>Bariatric surgery results in significant long-term weight loss, albeit with considerable variability. This study examines the prognostic significance of eating pathology as determined by a structured interview, the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV).<h4>Method</h4>Participants (N = 183) in this substudy of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium were assessed using the EDE-BSV, independent of clinical care, presur ...[more]

PMID: 27425771

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Project description:BackgroundDepression and binge eating disorder (BED) are prevalent among bariatric surgery candidates. Depression subtypes may be differentially related to obesity, such that the atypical subtype predicts poorer outcomes. However, no research has examined depression subtypes, BED, and weight loss in bariatric candidates.ObjectiveTo examine whether presurgical atypical depressive symptoms, compared with no depressive and melancholic depressive symptoms, were associated with higher rates of presurgical BED, binge eating severity, and poorer postsurgical weight loss trajectories among bariatric candidates.SettingAn outpatient Midwest bariatric clinic.MethodsParticipants were 345 adults (aged 46.27 ± 12.78 yr, 76% female; body mass index = 49.84 ± 8.51 kg/m2) who received a presurgical evaluation. Depression subtypes (melancholic, atypical, and no depressive symptoms) were categorized using the Beck Depression Inventory-II. BED diagnosis and severity were evaluated using the Eating Disorder Diagnostic Scale and Binge Eating Scale, respectively. Weight loss trajectories were calculated as percent total weight loss postsurgery.ResultsUsing no depression as the referent, participants reporting melancholic symptoms (odds ratio = 7.60, P < .001 confidence interval95 [2.59-22.28]) and atypical symptoms (odds ratio = 10.11, P < .01 confidence interval95 [2.69-37.94]) were more likely to meet criteria for BED. Patients with atypical depressive symptoms exhibited the highest binge eating severity scores (mean = 23.03). Depression subtypes did not predict percent total weight loss trajectories within 18-months postbariatric surgery.ConclusionsPatients reporting preoperative atypical depressive symptoms were more likely to meet criteria for co-morbid BED diagnosis and have greater binge eating severity but did not have poorer weight loss within 18 months postsurgery. Future studies with longer-term follow-up and corresponding measures of postsurgical depression and binge eating pathology are warranted.

Dataset Information

Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.

Publications

Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.

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