title: Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates.
abstract: BACKGROUND
  Graze eating is defined as repetitive, unplanned eating of small amounts of food throughout the day. Little consensuses exist regarding whether graze eating, like binge eating disorder (BED), is characterized by feelings of loss of control (LOC). Furthermore, little is known about how patients who graze eat with and without LOC differ psychologically.
  
  
  OBJECTIVE
  The present study seeks to better characterize graze eating by examining differences between graze eating with LOC (+LOC) and without LOC (-LOC) among presurgical bariatric patients.
  
  
  METHODS
  A large, Midwestern academic medical center.
  
  
  METHODS
  The sample consisted of 288 adult bariatric surgery candidates (mean age 45.8, standard deviation [SD] 12.57) who underwent a presurgical psychological evaluation. Graze eating, BED, and other mental health diagnoses were evaluated using a semistructured interview. Participants were also administered the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and binge eating scale (BES). Data were collected using a retrospective chart review.
  
  
  RESULTS
  Among the 33% (n = 95) of the sample who reported preoperative graze eating, 32% (n = 30) also endorsed LOC. Graze eating, particularly with LOC, was associated with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnoses of anxiety disorders and BED, and multiple measures of internalizing dysfunction on the MMPI-2-RF.
  
  
  CONCLUSIONS
  Bariatric surgery candidates who graze eat experience a greater degree of overall distress and psychopathology including anxiety and depression. The minority who experience grazing+LOC appear to have even greater risk of psychopathology. Moreover, there appears to be significant overlap with BED. Future research should explore whether these 2 maladaptive eating patterns benefit from similar treatment.
authors.affiliation: Legacy Weight and Diabetes Institute, Portland, Oregon. Electronic address: kgoodpas@lhs.org.
authors.forename: Kasey P S
authors.initials: KPS
authors.lastname: Goodpaster
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Marek
authors.affiliation: Cleveland Clinic Bariatric & Metabolic Institute, Cleveland, Ohio.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Lavery
authors.affiliation: Cleveland Clinic Bariatric & Metabolic Institute, Cleveland, Ohio.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ashton
authors.affiliation: Cleveland Clinic Bariatric & Metabolic Institute, Cleveland, Ohio.
authors.forename: Julie
authors.initials: J
authors.lastname: Merrell Rish
authors.affiliation: Cleveland Clinic Bariatric & Metabolic Institute, Cleveland, Ohio.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Heinberg
mesh_terms: D001008:Anxiety Disorders / Q000209:etiology; D050110:Bariatric Surgery / Q000523:psychology*; D056912:Binge-Eating Disorder / Q000523:psychology*; D003866:Depressive Disorder / Q000209:etiology; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D000068356:Self-Control / Q000523:psychology
keywords: Bariatric surgery candidates; Binge eating disorder; Binge eating scale; Graze eating; MMPI-2-RF; Obesity; Presurgical psychological evaluation