Experiences of loss of control eating in women after bariatric surgery: A qualitative study

Abstract

Objective Loss of control (LOC) eating following bariatric surgery remains insufficiently understood, reflected in a lack of clear conceptualization, valid measurements, and effective treatments. This study explored patients' perspectives on LOC eating post‐bariatric surgery, focusing on the relevance of the Diagnostic and Statistical Manual of Mental Disorders‐5 (DSM‐5) indicators of impaired control, and patients' experiences before (precipitating factors), during (eating patterns, perpetuating factors), and after the episodes (strategies used to stop eating). Methods This was a qualitative study using descriptive phenomenology. Participants were adults who have undergone gastric bypass or sleeve gastrectomy and self‐reported recent LOC eating. Data were collected by semi‐structured interviews and analyzed using a combined inductive and deductive approach. Results Participants were all women (N = 15; age: 34.5 ± 9.2 years). Results suggested that (1) except for feeling disgusted, guilty, or depressed after eating, other DSM‐5 indicators did not seem to be highly relevant to this bariatric cohort; (2) LOC eating could occur across contexts, with food access, boredom, and food craving being consistent triggers; (3) the food amount consumed during a LOC episode was not necessarily considered excessive; (4) “mindlessness” and “satisfying hedonic, physiological, and mental needs” were the main perpetuating factors of LOC eating; and (5) self‐talk and distracting attention were the most adopted strategies to stop eating. Discussion Study findings have implications concerning the conceptualization, measurement, and intervention of LOC eating among bariatric patients. For example, results suggested the need for more data to determine the appropriate indicators of LOC eating and the inclusion of boredom as an intervention target in bariatric patients. Public Significance Loss of control (LOC) eating is characterized by a sense of being unable to stop while eating. LOC eating is prevalent in patients who have undergone weight loss surgery and is associated with worse surgical outcomes. This qualitative study that explored post‐bariatric surgery patients' experiences of LOC eating will inform efforts to better assess and intervene in this disordered eating behavior, thus ultimately optimizing patients' health following weight loss surgery.

Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model

“… 15 Many bariatric surgery patients exhibited unhealthy dietary behaviors, such as overeating and grazing. The effects of weight loss caused by the surgery are usually extremely significant in the early postoperative period, some patients engaging in PA (such as walking or swimming) but exhibiting suboptimal dietary control may perceive that “weight loss continues due to participation in PA, even with occasional dietary lapses”, 36 this perception leads to an elevation in CB, further exacerbating dietary behaviors. Concurrently, poor dietary habits may attenuate CB’s direct effect on PA.…”

Multidisciplinary combined treatment based on bariatric surgery for metabolic syndrome: a review article

“…Furthermore, it was discovered by Kalarchian et al . 126 that 46% of the patients experienced symptoms of loss of control (LOC) eating after bariatric surgery, which was also related to postoperative weight regain.…”