title: Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.
abstract: OBJECTIVE
  Bariatric surgery results in significant long-term weight loss, albeit with considerable variability. This study examines the prognostic significance of eating pathology as determined by a structured interview, the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV).
  
  
  METHODS
  Participants (N = 183) in this substudy of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium were assessed using the EDE-BSV, independent of clinical care, presurgery and annually postsurgery. We examined eating pathology and experiences at several frequency thresholds (present, ≥ monthly, ≥ weekly) over 3 years, and utilized mixed models to test their associations with percentage weight loss from baseline at years 1, 2, and 3.
  
  
  RESULTS
  The prevalence of several forms of eating pathology declined pre- to 1-year postsurgery, including ≥weekly objective bulimic episodes (11.6-1.3%), loss of control (LOC) eating (18.3-6.2%) and picking/nibbling (36.0-20.2%) (P for all <0.01), and regular evening hyperphagia (16.5-5.0%, P = 0.01), but not cravings (P = 0.93). Mean EDE global score, and hunger and enjoyment scores, also declined (P for all <0.01). These metrics remained lower than baseline through year-3 (P for all <0.01). Presurgery eating variables were not related to weight loss (P for all ≥0.05). However, postsurgery higher EDE global score and greater hunger were independently associated with less weight loss postsurgery (P for both ≤0.01), while cravings were associated with greater weight loss (P = 0.03).
  
  
  CONCLUSIONS
  Pathological eating behaviors and experiences are common presurgery and improve markedly following surgery. Postsurgery pathological eating-related experiences and attitudes and hunger may contribute to suboptimal weight loss. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1058-1067).
authors.affiliation: Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devlin
authors.affiliation: Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Penninsylvania.
authors.forename: Wendy C
authors.initials: WC
authors.lastname: King
authors.affiliation: School of Nursing, Duquesne University, Pittsburgh, Penninsylvania.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kalarchian
authors.affiliation: Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Penninsylvania.
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: White
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Penninsylvania.
authors.forename: Marsha D
authors.initials: MD
authors.lastname: Marcus
authors.affiliation: Sanford Health System, Fargo, North Dakota.
authors.forename: Luis
authors.initials: L
authors.lastname: Garcia
authors.affiliation: Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D001294:Attitude to Health; D050110:Bariatric Surgery; D005247:Feeding Behavior / Q000502:physiology; D001068:Feeding and Eating Disorders / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006815:Hunger / Q000502:physiology; D006963:Hyperphagia / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology*
keywords: bariatric surgery; binge eating; disordered eating; hunger; loss of control eating