Background

Disordered eating patterns may occur following surgery and are associated with poorer weight loss outcomes. To better identify individuals at risk, this prospective study examines disordered eating prior to and following bariatric surgery with the aim of clarifying when problematic eating may emerge post-op.

Methods

A prospective cohort of patients (N=96, 83.3% female, 71.9% Caucasian, Mean pre-operative BMI= 45.89 kg/m2) who underwent bariatric surgery at two Centers of Excellence completed the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV) at three time points (pre-op, 6-months post-op and 12-months post-op).

Results

Significant differences were found in EDE-BSV Global (p <.001) Restraint (p <.001), Shape Concern (p <.001) and Weight Concern (p <.001) scores over time, with patients reporting fewer disordered eating behaviors and attitudes after surgery. By contrast, there was no difference in the proportion of patients reporting Objective Overeating Episodes, Loss of Control Eating, Graze Eating or Nocturnal Eating at baseline as compared to post-op time points. Neither Objective Bulimic Episodes (OBE) nor Subjective Bulimic Episodes (SBE) were reported at baseline or six months post-op; only one participant reported clinically significant SBE's at one year follow-up.

Conclusions

This study suggests that problematic eating-related behaviors and attitudes improve within the first year after surgery, even though changes in clinically significant disordered eating behaviors were not identified in this sample of well-optimized patients. Given evidence for reduction in eating pathology within the first year post-op, patients may most benefit from monitoring for re-emergence of disordered eating behaviors after this time.