title: Positive response to binge eating intervention enhances postoperative weight loss.
abstract: BACKGROUND
  Binge eating disorder has been suggested as a predictor of negative outcomes, including weight regain and poorer weight loss, particularly if the symptoms (e.g., loss of control eating) remain after surgery. Binge eating disorder has been viewed by some as a contraindication for weight loss surgery, and preoperative treatment has been recommended to help reduce binge eating behaviors. The objective of the present study was to evaluate whether the response to a preoperative binge eating intervention related to differential postoperative weight loss at an academic medical center.
  
  
  METHODS
  A total of 128 bariatric surgery candidates completed a brief cognitive behavioral group treatment for binge eating behaviors. The patients were categorized as positive responders or nonresponders according to the postintervention outcomes, including binge eating symptoms and episodes. The percentage of excess body weight loss (%EBWL) was measured at 6 and 12 months after surgery.
  
  
  RESULTS
  Across all bariatric procedures, the positive responders to the brief binge eating intervention had lost significantly more weight at 6 months (46% EBWL versus 38% EBWL) and 12 months (59% EBWL versus 50% EBWL) postoperatively. The results for a subsample of Roux-en-Y gastric bypass patients (n = 89) were also significant, with 53% EBWL for the responders and 42% EBWL for the nonresponders at 6 months and 68% EBWL versus 54% EBWL at 12 months postoperatively, respectively.
  
  
  CONCLUSIONS
  The response to binge eating treatment could be an important predictor of postoperative weight loss. The results from the present study provide support for patients who respond to preoperative binge eating treatment having enhanced surgical outcomes.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA. ashtonk@ccf.org
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ashton
authors.forename: Leslie
authors.initials: L
authors.lastname: Heinberg
authors.forename: Amy
authors.initials: A
authors.lastname: Windover
authors.forename: Julie
authors.initials: J
authors.lastname: Merrell
mesh_terms: D050110:Bariatric Surgery; D001521:Behavior Therapy / Q000379:methods*; D056912:Binge-Eating Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D015992:Body Mass Index; D001835:Body Weight; D002032:Bulimia / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*