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Food Addiction and Binge Eating Impact on Weight Loss Outcomes Two Years Following Sleeve Gastrectomy Surgery



Emerging evidence suggest that problematic eating behaviors such as food addiction (FA) and binge eating (BE) may alter following bariatric surgery (BS) and impact weight outcomes. We aimed to examine the prevalence of FA and BE and their associations with weight outcomes 2 years post-sleeve gastrectomy (SG).


Forty-five women (mean age 32.4 ± 10.9 years) who underwent SG and completed 24 months of follow-up were evaluated prospectively at pre-, 3-, 6-, 12-, and 24-month post-SG. Data collected included anthropometrics, nutritional intake, and lifestyle patterns. The Yale Food Addiction Scale (YFAS) and the Binge Eating Scale (BES) were used to characterize FA and BE, respectively.


Pre-surgery FA and BE were identified in 40.0% and 46.7% of participants, respectively. Following SG, FA and BE prevalence was 10.0%, 5.0%, 29.4%, and 14.2% (P = 0.007), and 12.5%, 4.9%, 18.4%, and 19.4% (P < 0.001) at 3, 6, 12, and 24 months, respectively. Women with BE at baseline gained significantly more weight from the nadir compared to non-BE women at baseline (P = 0.009). There was no relationship between FA at baseline and weight (P = 0.090). Weight regained from the nadir positively correlated with BES scores at baseline (r = 0.374, P = 0.019).


FA and BE tend to decrease during the early postoperative period, but remains in a notable rates return by 2 years post-SG. Moreover, pre-surgical BE was related to higher weight-regain. Proper management pre-BS should include a comprehensive eating pathologies assessment, as these pathologies may remain or re-emerge post-surgery and lead to worse weight outcomes.

Graphical Abstract

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Fig. 1
Fig. 2


BE :

Binge eating


Binge eating scale

BS :

Bariatric surgery


Body mass index


Excess weight loss

FA :

Food addiction

SG :

Sleeve gastrectomy


Total body weight loss


Yale Food Addiction Scale


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Authors and Affiliations



The authors’ responsibilities were as follows: TBP designed the research; TBP and SP performed the research; TBP and UK analyzed the data; and TBP, UK, SSD, JS, and NS wrote the manuscript. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Tair Ben-Porat.

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Ethical Approval

All procedures performed in this study were approved by the institutional review board of participating hospital, Hadassah Ein Kerem University medical center and in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The RCT study was pre-registered on the NIH registration website (TRIAL no. NCT02483026).

Informed Consent

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

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The authors declare no competing interests.

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Key Points

• Food addiction (FA) and binge eating (BE) were prevalent in up to 47% of women prior to sleeve gastrectomy (SG)

• Both FA and BE decreased during early period among women post-SG, but notable rates were found at 2 years

• Pre-surgical BE was related to higher weight regain from the nadir at 2 years post-SG

• A comprehensive eating pathologies’ evaluation should be included before surgery

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Ben-Porat, T., Košir, U., Peretz, S. et al. Food Addiction and Binge Eating Impact on Weight Loss Outcomes Two Years Following Sleeve Gastrectomy Surgery. OBES SURG 32, 1193–1200 (2022).

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