Eating behavior as a prognostic factor for weight loss after gastric bypass.
BACKGROUND
Binge-eating disorder (BED) may be associated with unsatisfactory weight loss in obese patients submitted to bariatric procedures. This study aims to investigate whether the presence of binge eating before Roux-en-Y gastric bypass (RYGBP) influences weight outcomes.


METHODS
In a prospective design, 216 obese patients (37 males, 178 females, BMI=45.9 +/- 6.0 kg/m2) were assessed for the lifetime prevalence of BED and classified at structured interview into 3 subgroups: no binge eating (NBE=43), sub-threshold binge eating (SBE=129), and binge-eating disorder (BED=44). All patients were encouraged to take part in a multidisciplinary program following surgery, and weight loss at follow-up was used as the outcome variable.


RESULTS
At 1-year follow-up, NBE patients (n=41) showed percent excess BMI loss (%EBL) significantly higher than SBE patients (n=112) (P=0.027), although this effect was not significantly different between NBE and BED patients (n=44). At 2-year follow-up, NBE patients (n=33) showed %EBL higher than SBE (n=64) (P=-0.003) and BED patients (n=34) (P<0.001). Nevertheless, we found no significant weight loss differences between SBE (subclinical) and BED (full criteria) patients at any period of follow-up. Preliminary results at 3-year follow-up suggest that such an effect may be enduring.


CONCLUSIONS
The presence of a history of binge eating prior to treatment is associated with poorer weight loss in obese patients submitted to RYGBP. Because BED is highly prevalent in obese patients seeking bariatric surgery, its early recognition and treatment may be of important clinical value.
Sallet
Paulo C
PC
Department and Institute ofPsychiatry, Faculty of Medicine, University of São Paulo, Brazil. pcsallet@usp.br
Sallet
José A
JA
Dixon
John B
JB
Collis
Eliane
E
Pisani
Carlos E
CE
Levy
Andréa
A
Bonaldi
Fábio L
FL
Cordás
Taki A
TA
D000328:Adult; D001828:Body Image; D015992:Body Mass Index; D002032:Bulimia / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery*; D011237:Predictive Value of Tests; D015995:Prevalence; D016896:Treatment Outcome; D015431:Weight Loss