The Influence of Eating Behavior and Eating Pathology on Weight Loss after Gastric Restriction Operations

Background: Eating behavior before surgery is considered to have great predictive value for the course of weight after surgery. The present study investigates the predictive value of three dimensions of eating behavior and disturbed eating on weight loss after gastric restriction surgery. Methods: 149 patients consisting of 47 males (32%), 102 females (68%), with mean age 38.8+10.3 years, were investigated by means of a structured interview and the Three Factor Eating Questionnaire (TFEQ) before (T1) and at least 12 months after (T2) (14.0+1.5 months) gastric restriction surgery. Results: Mean BMI before surgery was 50.9±8.1 kg/m²; postoperatively, the BMI decreased on average by 12.8 kg/m² to 38.6±6.8 kg/m² (t=22.7, P=0.000) at T2. Point-prevalence of Binge Eating Disorder (BED) according to DSM-IV was 2.0%, and lifetime-prevalence 7.4%, respectively. Of our sample, 20.1% reported current binge episodes without fulfilling all criteria for BED. An eating pathology consisting of continual eating ("grazing") was reported in 19.5% of the patients. At T2, patients with a weight loss of at least 25% of their pre-surgery weight indicated significantly less hunger and disinhibition compared with patients with less weight loss. Patients with a distinct craving for sweets after surgery lost significantly less weight. Patients with binge episodes or "grazing" before surgery did not differ in average weight loss from patients without binge episodes or "grazing". Conclusion: Postoperative but not preoperative eating behavior is of predictive value for the extent of weight loss after gastric restriction surgery.