The Prognostic Significance of Regular Binge Eating in Extremely Obese Gastric Bypass Patients: 12-Month Postoperative Outcomes
J Clin Psychiatry 2006;67(12):1928-1935
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The prognostic significance of
binge eating for extremely obese patients who
undergo bariatric surgery is uncertain. We examined the
relation of preoperative binge eating to preoperative
presentation and 12-month postoperative outcomes.
Methods: 139 extremely obese gastric bypass
surgery patients completed assessments of binge
eating and eating disorders (Eating Disorder
Examination-Questionnaire version), body dissatisfaction
(Body Shape Questionnaire), depression (Beck
Depression Inventory), and self-esteem (Rosenberg
Self-Esteem Scale) before surgery and again 12 months postsurgery.
Results: At baseline, 60% of patients denied
binge eating, 16% reported binge eating infrequently
(less than once weekly), and 24% reported binge eating
at least weekly. At 12 months postsurgery, 8.8%
reported infrequent binge eating and only 0.7% reported
binge eating weekly. At baseline, infrequent binge eaters
and regular binge eaters differed little from each other
but had significantly elevated eating and
psychosocial problems relative to non-binge eaters. Statistically
significant and clinically robust improvements in
weight and in all measures of functioning were observed at
12 months postsurgery across all groups. At
12-month follow-up, patients who reported regular binge
eating at baseline had significantly higher levels of
eating-specific concerns (but not psychosocial concerns)
than the infrequent binge eaters and non-binge eaters;
the infrequent and non-binge eaters did not differ
from each other. Significant time-by-binge eating
interactions indicated that the regular versus infrequent
binge-eating groups improved differently over time;
infrequent binge eaters had sharper improvements
than regular binge eaters and non-binge eaters.
Conclusion: Binge eating is common in
extremely obese bariatric surgery candidates and is
associated with heightened eating and psychological
problems. Regular binge eating preoperatively, however, does
not appear to be a potent negative prognostic indicator
for gastric bypass surgery. Our findings, which are
limited to 12 months postsurgery, highlight substantial
improvements in weight and psychosocial
functioning, and these robust improvements differ little by