Compulsive eating and gastric bypass surgery: what does hunger have to do with it?
BACKGROUND
Binge eating and other patterns of disordered eating in obese patients need further investigation. In a previous study by this author, one-third of patients presenting for bariatric surgery met strict criteria for Binge Eating Disorder. It is important to clarify the role of such eating behaviors on outcome of surgery to determine whether treatments targeted specifically at these behaviors and associated psychological issues can improve surgical outcome. The aim of this paper is to raise awareness of the range of disordered eating patterns in bariatric patients, describe an approach used, and discuss issues reported by patients after surgery.


METHODS
Patients completed questionnaires before surgery (QWEP, BES, BDI) and were seen for a pre-surgery mental health evaluation. High risk patients were identified and invited to attend a post-surgery group (CBT approach) as a preventive measure to help them deal with eating patterns as well as emotional adjustment.


RESULTS
Disordered eating patterns can persist after surgery. While surgery may decrease actual physical hunger and reduce physical capacity for food, it is still possible to eat compulsively, although the patterns may change somewhat due to the surgical procedure.


CONCLUSIONS
Since long-term weight maintenance depends on post-operative changes in eating behaviors, it is important to identify patients at risk for a range of disordered eating patterns so that a comprehensive treatment plan that targets the eating disturbances and associated psychological components can be implemented.
Saunders
R
R
Center for Behavioral Change, 3212 Skipwith Rd., Suite 104, Richmond, VA 23294, USA. Risaunders@aol.com
D002032:Bulimia / Q000150:complications*; D003863:Depression / Q000150:complications*; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000150:complications / Q000628:therapy; D015390:Gastric Bypass; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires