Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study.
OBJECTIVE
This study examined the clinical significance of loss of control (LOC) over eating in bariatric surgery patients over 24 months of prospective, multiwave follow-ups.


METHODS
Three hundred sixty-one gastric bypass surgery patients completed a battery of assessments before surgery and at 6, 12, and 24 months following surgery. In addition to weight loss and LOC over eating, the assessments targeted eating disorder psychopathology, depression levels, and quality of life. The study was conducted between January 2002 and February 2008.


RESULTS
Prior to surgery, 61% of patients reported general LOC; postsurgery, 31% reported LOC at 6-month follow-up, 36% reported LOC at 12-month follow-up, and 39% reported LOC at 24-month follow-up. Preoperative LOC did not predict postoperative outcomes. In contrast, mixed models analyses revealed that postsurgery LOC was predictive of weight loss outcomes: patients with LOC postsurgery lost significantly less weight at 12-month (34.6% vs 37.2% BMI loss) and 24-month (35.8% vs 39.1% BMI loss) postsurgery follow-ups. Postsurgery LOC also significantly predicted eating disorder psychopathology, depression, and quality of life at 12- and 24-month postsurgery follow-ups.


CONCLUSIONS
Preoperative LOC does not appear to be a negative prognostic indicator for postsurgical outcomes. Postoperative LOC, however, significantly predicts poorer postsurgical weight loss and psychosocial outcomes at 12 and 24 months following surgery. Since LOC following bariatric surgery significantly predicts attenuated postsurgical improvements, it may signal a need for clinical attention.
Department of Psychiatry, Yale University School of Medicine, PO Box 208098, New Haven, CT 06520, USA. marney.white@yale.edu
Marney A
MA
White
Melissa A
MA
Kalarchian
Robin M
RM
Masheb
Marsha D
MD
Marcus
Carlos M
CM
Grilo
D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D015992:Body Mass Index; D002755:Choice Behavior; D003863:Depression / Q000150:complications; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology* / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss