Eating Pathology And Experience And Weight Loss In A Prospective Study Of Bariatric Surgery Patients: 3-Year Follow-Up

ObjectiveBariatric 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).MethodParticipants (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 3years, and utilized mixed models to test their associations with percentage weight loss from baseline at years 1, 2, and 3.ResultsThe 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).DiscussionPathological 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. (c) 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1058-1067)