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Randomized Controlled Trial
. 2024 Mar;20(3):261-266.
doi: 10.1016/j.soard.2023.09.017. Epub 2023 Sep 26.

Racial differences after bariatric surgery: 24-month follow-up of a randomized, controlled trial for postoperative loss-of-control eating

Valentina Ivezaj  1 , Abhaya Dilip  2 , Andrew J Duffy  3 , Carlos M Grilo  4
Affiliations
Randomized Controlled Trial

Racial differences after bariatric surgery: 24-month follow-up of a randomized, controlled trial for postoperative loss-of-control eating

Valentina Ivezaj et al. Surg Obes Relat Dis. 2024 Mar.

Abstract

Background: While some bariatric surgery outcomes vary by race/ethnicity, less is known about racial/ethnic differences in loss-of-control (LOC) eating and psychosocial outcomes post-surgery.

Objective: This prospective study examined and extended initial short-term findings regarding racial differences in post-bariatric surgery LOC eating and weight loss to longer-term outcomes through 24-month follow-ups.

Setting: Academic medical center in the United States.

Methods: Participants were 140 patients (46.4% non-White) in a 3-month randomized, controlled trial for LOC eating performed about 6 months after bariatric surgery. Participants were reassessed at 6, 12, 18, and 24 months after treatment ended (about 33 mo after surgery). Doctoral assessors administered the Eating Disorder Examination-Bariatric Surgery Version interview to assess LOC eating and eating-disorder psychopathology at 12- and 24-month follow-ups. The Beck Depression Inventory II was repeated, and measured weight was obtained at all follow-ups.

Results: White patients had significantly greater percent excess weight loss at all follow-ups than non-White patients (p < .03). White patients reported significantly more LOC eating at 12- (p = .004) and 24-month (p = .024) follow-ups and significantly greater eating disorder psychopathology at 12-month follow-up (p < .028). Racial groups did not differ significantly in eating disorder psychopathology at 24-month follow-ups or in Beck Depression Inventory II depression scores at any follow-ups.

Conclusions: Our findings suggest that among patients with LOC eating after bariatric surgery, non-White patients attain a lower percent excess weight loss than White patients but have comparable or better outcomes in LOC eating, associated eating disorder psychopathology, and depression over time.

Keywords: Bariatric surgery; Binge eating; Loss-of-control eating; Obesity; Race.

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Conflict of interest statement

Potential conflicts of interest: The authors declare no conflicts of interest. Dr. Grilo reports broader interests, including Honoraria for lectures and CME activities at universities and scientific conferences, and Royalties from Guilford Press and Taylor & Francis Publishers for academic books.

Figures

Figure 1.
Figure 1.. Individual variability in percent excess weight loss by race from pre-surgery to the study 24-month follow-up (about 33 months post-surgery).
Figure 2.
Figure 2.. Percentage with LOC-eating abstinence by race at posttreatment, 12-month, and 24-month follow-up assessments
*p<.05; **p<.01; ***p<.001
See this image and copyright information in PMC

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