Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding.
BACKGROUND
The authors investigated the outcome of morbidly obese patients with binge eating disorder (BED) treated surgically with laparoscopic adjustable gastric banding.


METHODS
The 5-year outcomes of 130 patients with BED and 249 patients without BED are described. The diagnosis of BED was made preoperatively and all patients with BED were supported with psychological therapy.


RESULTS
Patients with and without BED had similar BMI levels before surgery. More patients with than without BED had depressive symptoms and associated minor disturbances of eating behavior (night eating and grazing). Percent excess weight loss (%EWL) in the first 5 years after surgery was similar in patients with and without BED. The percentage of BED patients showing %EWL >50% at the 5-year evaluation was 23.1, and 25.7% in non-BED patients. The percentage of patients showing weight regain in the last 4 years of follow-up was similar in binge eaters (20.8%) and in non-binge eaters (22.5%). The 5-year frequency of gastric pouch and esophageal dilatation was significantly higher in binge eaters than in non-binge eaters (25.4 vs 17.7 %, P<0.05 and 10.0 vs 4.8%, P<0.05, respectively). Binge eaters underwent a higher number of postoperative band adjustments than non-binge eaters (3.0+/-2.1 vs 2.6+/-1.9, P<0.05) and the maximum band fill after surgery was higher in the BED patients than in non-BED patients (3.2+/-1.2 vs 2.8+/-1.3 ml, P<0.01).


CONCLUSIONS
Morbidly obese patients with BED supported by adequate psychological treatment can have good outcomes after gastric banding.
Busetto
Luca
L
Obesity Unit, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. luca.busetto@unipd.it
Segato
Gianni
G
De Luca
Maurizio
M
De Marchi
Francesco
F
Foletto
Mirto
M
Vianello
Marinella
M
Valeri
Marzia
M
Favretti
Franco
F
Enzi
Giuliano
G
D000223:Adaptation, Psychological; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D015992:Body Mass Index; D002032:Bulimia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*