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Observational Study
. 2016 Nov;24(11):2327-2333.
doi: 10.1002/oby.21648. Epub 2016 Sep 12.

Binge-eating disorder and the outcome of bariatric surgery in a prospective, observational study: Two-year results

Ariana M Chao  1   2 , Thomas A Wadden  3 , Lucy F Faulconbridge  2 , David B Sarwer  4 , Victoria L Webb  5 , Jena A Shaw  2 , J Graham Thomas  6 , Christina M Hopkins  2 , Zayna M Bakizada  2 , Naji Alamuddin  7 , Noel N Williams  8
Affiliations
Observational Study

Binge-eating disorder and the outcome of bariatric surgery in a prospective, observational study: Two-year results

Ariana M Chao et al. Obesity (Silver Spring). 2016 Nov.

Abstract

Objective: A previous study reported that preoperative binge-eating disorder (BED) did not attenuate weight loss at 12 months after bariatric surgery. This report extends the authors' prior study by examining weight loss at 24 months.

Methods: A modified intention-to-treat population was used to compare 24-month changes in weight among 59 participants treated with bariatric surgery, determined preoperatively to be free of a current eating disorder, with changes in 33 surgically treated participants with BED. Changes were also compared with 49 individuals with obesity and BED who sought lifestyle modification for weight loss. Analyses included all available data points and were adjusted for covariates.

Results: At month 24, surgically treated patients with BED preoperatively lost 18.6% of initial weight, compared with 23.9% for those without BED (P = 0.049). (Mean losses at month 12 had been 21.5% and 24.2%, respectively; P = 0.23.) Participants with BED who received lifestyle modification lost 5.6% at 24 months, significantly less than both groups of surgically treated patients (P < 0.001).

Conclusions: These results suggest that preoperative BED attenuates long-term weight loss after bariatric surgery. We recommend that patients with this condition, as well as other eating disturbances, receive adjunctive behavioral support, the timing of which remains to be determined.

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Conflict of interest statement

The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Linear mixed-effects models for 24-month weight losses of participants in the three observational groups (for the modified ITT population). Values shown are mean (±standard error) percentage reduction in initial weight over 24 months for participants who had binge eating disorder (BED) and elected lifestyle modification (Lifestyle-BED; N=49) or bariatric surgery (Surgery-BED; N=33) or were free of BED and had bariatric surgery (Surgery-non-BED; N=59). Weight losses were estimated using linear mixed-effects models controlling for initial BMI, gender, type of surgery, age, ethnicity, and presence of diabetes.
Figure 2
Figure 2
Linear mixed-effects models for 24-month weight losses of participants who underwent laparascopic adjustable gastric banding (LAGB; N=35) vs Roux-en-Y gastric bypass (RYGB; N=57; Figure 2a). Figure 2b includes within surgery comparisons of LAGB-BED (n=14) vs LAGB-non-BED patients (n=21), as well as RYGB-BED (n=19) vs RYGB-non-BED patients (n=38). Values shown are mean (±standard error) percentage reduction in initial weight over 24 months. Weight losses were estimated using linear mixed-effects models controlling for initial BMI, gender, age, ethnicity, and presence of diabetes.
Figure 2
Figure 2
Linear mixed-effects models for 24-month weight losses of participants who underwent laparascopic adjustable gastric banding (LAGB; N=35) vs Roux-en-Y gastric bypass (RYGB; N=57; Figure 2a). Figure 2b includes within surgery comparisons of LAGB-BED (n=14) vs LAGB-non-BED patients (n=21), as well as RYGB-BED (n=19) vs RYGB-non-BED patients (n=38). Values shown are mean (±standard error) percentage reduction in initial weight over 24 months. Weight losses were estimated using linear mixed-effects models controlling for initial BMI, gender, age, ethnicity, and presence of diabetes.
Figure 3
Figure 3
Number of objective (a) and subjective (b) binge eating episodes in the prior 28 days at screening and 12 and 24 months.
Figure 3
Figure 3
Number of objective (a) and subjective (b) binge eating episodes in the prior 28 days at screening and 12 and 24 months.
See this image and copyright information in PMC

References

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