Yasmin Nasirzadeh1, Karin Kantarovich2, Susan Wnuk2,3,4, Allan Okrainec2,3,5, Stephanie E Cassin3,4,6, Raed Hawa2,3,4, Sanjeev Sockalingam7,8,9,10. 1. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. 3. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 4. Centre for Mental Health, University Health Network, Toronto, Ontario, Canada. 5. Division of General Surgery, University Health Network, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 6. Department of Psychology, Ryerson University, Toronto, Ontario, Canada. 7. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. Sanjeev.Sockalingam@uhn.ca. 8. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. Sanjeev.Sockalingam@uhn.ca. 9. Centre for Mental Health, University Health Network, Toronto, Ontario, Canada. Sanjeev.Sockalingam@uhn.ca. 10. Toronto General Hospital, 200 Elizabeth Street-8EN-228, Toronto, Ontario, M5G 2C4, Canada. Sanjeev.Sockalingam@uhn.ca.
Abstract
OBJECTIVES: We explored the severity of binge eating, loss of control over eating, emotional eating, and night eating before bariatric surgery and annually for 3 years following surgery. We also assessed the impact of post-operative eating psychopathology on weight outcomes. METHODS: Eight hundred forty-four patients participated in this prospective cohort study. Demographic factors, self-report measures of eating pathology (BES, NEQ, EES, EDE-Q), and weights (kg) were collected pre-surgery and annually for 3 years after surgery. RESULTS: The severity of problematic eating behaviors decreased after surgery and remained lower than baseline throughout follow-up. An increase was noted in binge eating scores (change in mean score ± SD = 0.85 ± 4.71; p = 0.002), emotional eating scores (2.00 ± 13.63; p = 0.033), and loss of control eating scores (1.11 ± 7.01; p < 0.001) after the first post-operative year that continued to the third post-operative year. There was also an increase in night eating scores between 2 and 3 years post-surgery (2.52 ± 8.00; p = 0.01). Higher 1-year post-operative binge eating scores were a significant predictor of lower 2-year % total weight loss (β = - 0.39, confidence interval (CI) - 1.23, - 0.16, p = 0.012). CONCLUSIONS: The severity of problematic eating behaviors decrease after bariatric surgery, but increase significantly between the first and third post-operative years. Binge Eating Scale score at 1 year post-surgery was the only significant predictor of reduced percent total weight loss at 2 years. Additional prospective studies with adequate power are required to assess the progression of these eating pathologies beyond 3 years and their impact on weight outcomes beyond 2 years.
OBJECTIVES: We explored the severity of binge eating, loss of control over eating, emotional eating, and night eating before bariatric surgery and annually for 3 years following surgery. We also assessed the impact of post-operative eating psychopathology on weight outcomes. METHODS: Eight hundred forty-four patients participated in this prospective cohort study. Demographic factors, self-report measures of eating pathology (BES, NEQ, EES, EDE-Q), and weights (kg) were collected pre-surgery and annually for 3 years after surgery. RESULTS: The severity of problematic eating behaviors decreased after surgery and remained lower than baseline throughout follow-up. An increase was noted in binge eating scores (change in mean score ± SD = 0.85 ± 4.71; p = 0.002), emotional eating scores (2.00 ± 13.63; p = 0.033), and loss of control eating scores (1.11 ± 7.01; p < 0.001) after the first post-operative year that continued to the third post-operative year. There was also an increase in night eating scores between 2 and 3 years post-surgery (2.52 ± 8.00; p = 0.01). Higher 1-year post-operative binge eating scores were a significant predictor of lower 2-year % total weight loss (β = - 0.39, confidence interval (CI) - 1.23, - 0.16, p = 0.012). CONCLUSIONS: The severity of problematic eating behaviors decrease after bariatric surgery, but increase significantly between the first and third post-operative years. Binge Eating Scale score at 1 year post-surgery was the only significant predictor of reduced percent total weight loss at 2 years. Additional prospective studies with adequate power are required to assess the progression of these eating pathologies beyond 3 years and their impact on weight outcomes beyond 2 years.
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