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Loss of Control Eating and Binge Eating in the 7 Years Following Bariatric Surgery

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Abstract

Background

Although bariatric surgery is an effective intervention for severe obesity, a subset of patients demonstrates suboptimal weight outcomes. Postoperative loss of control eating (LOCE) and binge eating may influence weight outcomes, though research has not examined differences by surgical procedure, or factors that predict postoperative LOCE. This study aimed to [1] characterize LOCE and binge eating disorder (BED) over a 7-year period following bariatric surgery; [2] examine concurrent, prospective, and cumulative relationships between LOCE and weight loss; [3] assess whether these associations are moderated by surgery type; and [4] evaluate predictors of LOCE.

Methods

Participants were 2156 patients who underwent laparoscopic adjustable gastric banding (LAGB) or Roux-n-Y gastric bypass (RYGB) in the multi-center Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Generalized linear mixed models examined relationships between LOCE and percent weight loss and predictors of LOCE.

Results

LOCE and BED initially declined then increased after surgery, with a notable number of de-novo cases (25.6% and 4.8%, respectively). LOCE was related to less concurrent but not prospective or cumulative percent weight loss. Self-monitoring of eating, higher daily eating frequency, older age, male gender, and higher self-esteem were associated with a lower likelihood of LOCE.

Conclusions

Results suggest that LOCE and binge eating are clinically relevant behaviors that may impede weight loss, and findings highlight the importance of ongoing assessment of maladaptive eating following surgery.

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Funding

LABS-2 was funded by a cooperative agreement by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grants James.Mitchell@SanfordHealth.org (University of Pittsburgh, Data Coordinating Center); U01-DK66667 and UL1-RR024996 (Columbia- Presbyterian in collaboration with Cornell University Medical Center Clinical and Translational Research Center [CTRC]); U01-DK66568 and M01RR-00037 (University of Washington in collaboration with Cornell University Medical Center CTRC); U01-DK66471 (Neuropsychiatric Research Institute); U01-DK66526 (East Carolina University); U01-DK66585 and UL1- RR024153 (University of Pittsburgh Medical Center in collaboration with Cornell University Medical Center CTRC); and U01-DK66555 (Oregon Health & Science University).

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Authors and Affiliations

  1. Sanford Center for Bio-behavioral Research, Fargo, ND, USA

    Kathryn E. Smith, Molly Orcutt, Kristine J. Steffen, Ross D. Crosby, Li Cao, Luis Garcia & James E. Mitchell

  2. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA

    Kathryn E. Smith, Molly Orcutt, Ross D. Crosby & James E. Mitchell

  3. Fargo VA Health Care System, Fargo, ND, USA

    Molly Orcutt

  4. Department of Pharmaceutical Sciences, College of Pharmacy, Nursing, and Alliances, North Dakota State University, Fargo, ND, USA

    Kristine J. Steffen

  5. Sanford Health, Fargo, ND, USA

    Luis Garcia

  6. Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA

    Luis Garcia

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  1. Kathryn E. Smith
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  7. James E. Mitchell
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Smith, K.E., Orcutt, M., Steffen, K.J. et al. Loss of Control Eating and Binge Eating in the 7 Years Following Bariatric Surgery. OBES SURG 29, 1773–1780 (2019). https://doi.org/10.1007/s11695-019-03791-x

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