Eating Disorders and Eating Behavior Pre- and Post-bariatric Surgery

Abstract

1. To present an overview of various types of eating pathology prior to bariatric surgery 2. To present the course of eating pathology after bariatric surgery 3. To discuss the implications of eating pathology for bariatric surgery outcome

Problematic Eating Behaviors and Eating Disorders Associated with Bariatric Surgery

“…21 Rates of BED have varied considerably across studies 10,30 due to methodological differences, including over-reliance on self-report instruments and retrospective accounts versus structured clinical assessments. 31 In addition, there is currently no standardized approach to conducting the pre-surgical psychological interview, which can lead to biased estimates of BED and psychopathology. Ideally, clinicians and researchers would evaluate current eating and other forms of psychopathology using gold standard approaches, such as the Eating Disorders Examination (EDE) 32 , a structured clinical interview that assesses dietary restraint, as well as eating, weight, and shape concerns, and has been adapted for use with bariatric surgery patients (The EDE-Bariatric Surgery Version; EDE-BSV) and the Structured Clinical Interview (SCID-5) for DSM-5 disorders 33 , respectively.…”

“…Ideally, clinicians and researchers would evaluate current eating and other forms of psychopathology using gold standard approaches, such as the Eating Disorders Examination (EDE) 32 , a structured clinical interview that assesses dietary restraint, as well as eating, weight, and shape concerns, and has been adapted for use with bariatric surgery patients (The EDE-Bariatric Surgery Version; EDE-BSV) and the Structured Clinical Interview (SCID-5) for DSM-5 disorders 33 , respectively. The EDE is lengthy to administer and requires training, and so it is not widely used 31 but does have a validated questionnaire form, the EDEQ 34 , that can be used instead. Other validated eating disorder questionnaires, including the Eating Inventory 35 can be used to assess cognitive restraint over eating, LOC eating or disinhibited eating, and hunger.…”

“…Numerous studies have been conducted, but the majority do not support a relationship, and only a few support that BED is related to poorer weight loss outcomes. 31 For this reason, binge eating and BED is not considered to be a contraindication for bariatric surgery. However, patients with pre-surgical binge eating/BED should be closely monitored after surgery 31 because there is compelling evidence that disordered eating behaviors can reemerge after surgery.…”

“…31 For this reason, binge eating and BED is not considered to be a contraindication for bariatric surgery. However, patients with pre-surgical binge eating/BED should be closely monitored after surgery 31 because there is compelling evidence that disordered eating behaviors can reemerge after surgery. 31,[36][37][38]…”

Patients’ strategies for eating after gastric bypass surgery: a qualitative study

“…Research also suggests that both pre-and postoperative eating behaviours predict weight loss. 17,18 Thus, psychological indicators such as the occurrence of 'emotional eating' before surgery have been found to correlate with failure or early weight regain after surgery, 19,20 whereas patients without eating disorders before surgery have been found to develop disordered eating after surgery. 21 These general observations are supported by a recent study that found that patients who manage to change their eating habits after the operation are more likely to succeed with weight loss.…”