Eating Pathology and Experience and Weight Loss in a Prospective Study of Bariatric Surgery Patients: 3-Year Follow-Up
Open accessAbstract
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).
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Emotion-based eating is associated with emotion dysregulation, poor emotion regulation skills, low distress tolerance, dietary restraint, loss of control of eating, poor awareness of hunger/fullness signals, body image dissatisfaction, internalized shame, and low self-compassion.
“In addition to depression, emotion-based eating is associated with many other factors, including emotion dysregulation, poor emotion regulation skills, low distress tolerance, dietary restraint, loss of control of eating, poor awareness of hunger/fullness signals, body image dissatisfaction, internalized shame, and low self-compassion (24–29).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [28]
The Methods (Measures) assess restraint, loss-of-control eating, hunger and shape concerns, but do not assess emotion-based eating. The Results and Discussion relate these measures to surgery and weight loss, not to emotion-based eating. Searches for emotional eating, emotion dysregulation, distress tolerance, shame and self-compassion found no passage establishing the claimed associations. (LLM, conf=0.76)
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An examination of emotional and loss-of-control eating after sleeve gastrectomy surgery
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Preoperative inhibitory control predicts weight loss 1 year after bariatric surgery
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Interrater reliability of the Eating Disorder Examination among postbariatric patients
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Daily Timing of Meals and Weight Loss After Bariatric Surgery: A Systematic Review
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Psychosocial and behavioral correlates of weight loss 12 to 15 years after bariatric surgery
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Accuracy of Self-Reported Height and Weight Among Sleeve Gastrectomy Patients with Disordered Eating
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Predictors of Success in Bariatric Surgery
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Weight Regain and Ingestive Behavior in Women after Metabolic Surgery
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Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating
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Do pre-surgery eating habits affect weight loss one year following a sleeve gastrectomy?
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Psychometric properties of the eating loss of control scale among postbariatric patients
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EVALUACIÓN PSIQUIÁTRICA EN CIRUGÍA BARIÁTRICA: ESTUDIOS LABS Y EL CICLO DE GARTNER
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Eating Disorders and Bariatric Surgery
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Psychological Issues After Bariatric Surgery
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- Authors
- Devlin, M. J., King, W. C., Kalarchian, M. A., White, G. E., Marcus, M. D., Garcia, L., Yanovski, S. Z., & Mitchell, J. E.
- Affiliations
- New York State Psychiatric Institute (US)
- University of Pittsburgh (US)
- Duquesne University (US)
- Sanford Medical Center (US)
- National Institutes of Health (US)
- Neuropsychiatric Research Institute (US)
- Corresponding author
- Devlin, Michael J.
- ORCID
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2016-07-18
- Volume
- 49
- Issue
- 12
- Pages
- 1058-1067
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC5161707
- OpenAlex
- W2486464521
- Cited by
- 101
- References
- 39
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 16 · 2019: 17 · 2018: 11 · 2017: 9 · 2016: 3 · 2013: 1
- FWCI
- 17.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DSS‐U01DK066557, U01‐DK66667, R01 DK084979)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- bariatric surgery, eating pathology, weight loss, loss of control eating, craving, hunger, eating disorder symptoms, postoperative outcomes
- MeSH terms
- Adult, Feeding and Eating Disorders, Attitude to Health, Feeding Behavior, Female, Follow-Up Studies, Humans, Hunger, Hyperphagia, Male, Middle Aged, Postoperative Care, Preoperative Care, Prospective Studies, Weight Loss, Bariatric Surgery
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