title: The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain.
abstract: BACKGROUND
  Maladaptive eating behaviors after bariatric surgery are thought to compromise weight outcomes, but little is known about their frequency over time.
  
  
  OBJECTIVE
  This study investigates the presence of subjective binge eating (SBE), objective binge eating (OBE) and picking and nibbling (P&N) before surgery and at different time periods postoperative, and their association with weight outcomes.
  
  
  METHODS
  This cross-sectional study assessed a group of patients before surgery (n=61), and three post-operative groups: 1) 90 patients (27 with laparoscopic adjustable gastric band (LAGB) and 63 with Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)) assessed during their 6month follow-up medical appointment; 2) 96 patients (34 LAGB and 62 LRYGB) assessed during their one year follow-up medical appointment; and 3) 127 patients (62 LAGB and 55 LRYGB) assessed during their second year follow-up medical appointment. Assessment included the Eating Disorders Examination and a set of self-report measures.
  
  
  RESULTS
  In the first ten months after surgery fewer participants reported maladaptive eating behaviors. No OBEs were reported at 6months. SBE episodes were present in all groups. P&N was the most frequently reported eating behavior. Eating behavior (P&N) was significantly associated with weight regain, and non-behavioral variables were associated with weight loss.
  
  
  CONCLUSIONS
  This study is cross-sectional study which greatly limits the interpretation of outcomes and no causal association can be made. However, a subgroup of postoperative patients report eating behaviors that are associated with greater weight regain. The early detection of these eating behaviors might be important in the prevention of problematic outcomes after bariatric surgery.
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal. Electronic address: econceicao@psi.uminho.pt.
authors.forename: Eva
authors.initials: E
authors.lastname: Conceição
authors.affiliation: University of North Dakota, School of Medicine and Health Sciences, Fargo, ND, United States; Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND 58103, United States.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Vaz
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Bastos
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ramalho
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
authors.forename: Cátia
authors.initials: C
authors.lastname: Silva
authors.affiliation: University of North Dakota, School of Medicine and Health Sciences, Fargo, ND, United States; Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND 58103, United States.
authors.forename: Li
authors.initials: L
authors.lastname: Cao
authors.affiliation: University of Porto, Faculty of Medicine, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Brandão
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
authors.forename: Paulo P P
authors.initials: PP
authors.lastname: Machado
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D002032:Bulimia / Q000523:psychology*; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015430:Weight Gain; D055815:Young Adult
keywords: Bariatric surgery; Binge eating; Maladaptive eating behaviors; Picking and nibbling; Weight outcomes