Binge eating does not increase bypass surgery risk

NEW YORK, Jan 17 (Reuters) Regular binge eating before surgery does not increase the risk of poor outcomes in the first year after gastric bypass surgery (also referred to as ''bariatric'' surgery), in extremely obese patients, according to a report in the Journal of Clinical Psychiatry.

''Whether or not individuals with binge eating problems represent a surgical risk or have a poor prognosis following surgery has been a topic of heated debate,'' Dr Marney A White told Reuters Health. ''Our study found that bariatric patients -- regardless of whether or not they binge eat before surgery -- show substantial weight losses in the 12-months following surgery.'' White from Yale University School of Medicine, New Haven, Connecticut and colleagues compared weight loss, depression, self-esteem, body dissatisfaction, and eating disorder features before surgery and at 12 months after surgery among 139 extremely obese patients.

Nearly 40 per cent of the patients reported binge eating at least once during the 28 days before surgery, the authors report. About ten per cent met criteria for binge eating disorder.

Although the binge-eating patients tended to be more distressed before surgery than those who did not binge, the binge eaters experienced greater reductions in depression after surgery, to the extent that there were no significant group differences at follow-up.

Body mass index declined over the 12 months after surgery to a similar extent among regular binge-eaters, infrequent binge-eaters, and non-binge-eaters, the researchers note.

Overall, the average body mass index (the ratio of body weight to height) was 51.7 before surgery and 33.3 one year after surgery.

''Overall, pre-operative binge eating does not appear to be a negative prognostic indicator for surgery in the initial 12-month period following surgery, in that patients -- regardless of binge eating status -- show dramatic improvements in terms of weight loss and psychosocial functioning,'' White said.

''For the most part, binge eating remitted following surgery,'' White added. ''However, those patients who reported preoperative binge eating did report slightly elevated eating-related disturbances following surgery. This underscores the need for continued follow-up care and the need to identify disturbed eating behaviors and/or psychosocial difficulties that may relate to longer-term outcomes.'' The team stresses the results are limited to the first year after surgery. ''We have planned follow-up studies to occur at later intervals to determine whether these findings persist,'' White said. ''In particular, we are interested in the influence of binge eating in the context of the weight loss plateau and re-gain that occurs in the 2-10 year interval.'' REUTERS BDP KP0833