title: Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity.
abstract: BACKGROUND
  Weight loss surgery induces a marked change in eating behavior. However, not much work has been done characterizing the eating behavior after weight loss surgery. We conducted a detailed analysis of patients' eating behavior 18-35 months after Roux-en-Y gastric bypass surgery, determined whether preoperative eating disorders might be associated with non-normative postoperative eating, and examined the association of such eating behaviors with weight loss and psychopathology.
  
  
  METHODS
  A sample of 59 patients who had undergone Roux-en-Y gastric bypass was interviewed in person after surgery about a range of eating behaviors, including binge eating, chewing and spitting out food, picking at and nibbling food, and nocturnal eating and compensatory behaviors such as vomiting and laxative and diuretic misuse. An established semistructured interview was used. The prevalence of preoperative eating disorders was assessed retrospectively. The eating-related and general psychopathology and quality of life were assessed using self-report questionnaires before and after surgery.
  
  
  RESULTS
  Subjective bulimic episodes were reported by 25% and vomiting for weight and shape reasons by 12% of the participants, on average, 2 years after surgery. Subjective bulimic episodes were significantly associated with a preoperative binge eating disorder, with more eating-related and general psychopathology after surgery, and with less weight loss.
  
  
  CONCLUSIONS
  A substantial subgroup of patients with a preoperative eating disorder will develop binge eating after surgery that might be associated with less weight loss. A subsample will start vomiting for weight and shape reasons after bariatric surgery. Clinicians must probe carefully for these behaviors postoperatively to identify patients in need of treatment of pathological eating behaviors.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Erlangen, Germany. martina.dezwaan@uk-erlangen.de
authors.forename: Martina
authors.initials: M
authors.lastname: de Zwaan
authors.forename: Anja
authors.initials: A
authors.lastname: Hilbert
authors.forename: Lorraine
authors.initials: L
authors.lastname: Swan-Kremeier
authors.forename: Heather
authors.initials: H
authors.lastname: Simonich
authors.forename: Kathy
authors.initials: K
authors.lastname: Lancaster
authors.forename: L Michael
authors.initials: LM
authors.lastname: Howell
authors.forename: Tim
authors.initials: T
authors.lastname: Monson
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D056912:Binge-Eating Disorder / Q000453:epidemiology*; D002032:Bulimia / Q000453:epidemiology; D015897:Comorbidity; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D011184:Postoperative Period; D011788:Quality of Life; D014839:Vomiting / Q000453:epidemiology*; D015431:Weight Loss