title: Stability of problematic eating behaviors and weight loss trajectories after bariatric surgery: a longitudinal observational study.
abstract: BACKGROUND
  The literature is rather mixed regarding the stability and the role of pre- and postoperative problematic eating behaviors (PEBs) on weight outcomes after bariatric surgery.
  
  
  OBJECTIVE
  To investigate the stability of loss of control (LOC) eating and picking and/or nibbling from pre- to postoperative assessments, and to investigate whether pre- and postoperative PEBs are predictors of different weight loss trajectories.
  
  
  METHODS
  Central Hospital, University, Portugal.
  
  
  METHODS
  This longitudinal study assessed LOC eating and picking and/or nibbling before and approximately 2 years after laparoscopic adjustable gastric banding or Roux-en-Y gastric bypass through face-to-face interviews and 2 self-report measures. Weight across follow-up time was retrieved from hospital charts. Of the 130 patients invited to participate in the study, 100 were assessed preoperatively, and of these, 61 were also assessed postoperatively.
  
  
  RESULTS
  Frequency of PEBs is similar pre- and postoperatively (37.7% and 45.9%, respectively) (McNemar χ2P = .832). Yet, about 40% ceased preoperative PEBs. Those with LOC preoperatively were more likely to develop picking and/or nibbling postoperatively (McNemar χ2P<.05). About 39.5% developed PEBs de novo after surgery. The presence of PEBs postoperatively was a significant predictor of different weight loss trajectories after both laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass. Worse weight loss outcomes were found particularly at 17-20 months postsurgery. Preoperative PEBs were not a significant predictor.
  
  
  CONCLUSIONS
  Our data do not support the stability of all PEBs across time, highlighting that the absence of preoperative PEBs does not preclude an unfavorable weight loss outcome after surgery. Postoperative but not preoperative PEBs are predictors of poorer weight loss trajectories after surgery.
authors.affiliation: School of Psychology, University of Minho, Braga, Portugal. Electronic address: econceicao@psi.uminho.pt.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Conceição
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota; University of North Dakota, School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pinto-Bastos
authors.affiliation: School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Arrojado
authors.affiliation: Faculty of Medicine, University of Porto, Hospital de São João, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Brandão
authors.affiliation: School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Paulo P P
authors.initials: PPP
authors.lastname: Machado
mesh_terms: D000328:Adult; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D015390:Gastric Bypass / Q000523:psychology*; D015391:Gastroplasty / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D010535:Laparoscopy / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery; D062410:Snacks / Q000523:psychology; D015431:Weight Loss / Q000502:physiology*
keywords: Loss of control eating; Nibbling; Picking; Predictors of outcome; Problematic eating behaviors; Trajectories of weight loss