Bariatric Surgery and Binge Eating Disorder: Should Surgeons Care About It? A Literature Review of Prevalence and Assessment Tools

Abstract

BACKGROUND: Eating pathologies among bariatric surgery candidates are common and associated with adverse surgical outcomes, including weight regain and low quality of life. However, their assessment is made difficult by the great variety and inconsistent use of standardized measures. OBJECTIVE: The purpose of this review was to synthesize current knowledge on the prevalence of binge eating disorder (BED) in presurgical patients and to make a critical appraisal of assessment tools for BED. METHODS: A search was conducted on PubMed, Scopus, and Web of Science databases from January 1994 to March 2017. Data were extracted, tabulated and summarized using a narrative approach. RESULTS: A total of 21 observational studies were reviewed for data extraction and analysis. Prevalence of BED in bariatric populations ranged from 2% to 53%. Considerable variation in patient characteristics and in BED assessment measures was evident among the studies. In addition, several methodological weaknesses were recognized in most of the studies. Ten different psychometric instruments were used to assess BED. Clinical interviews were used in only 12 studies, though this is the preferred tool to diagnose BED. CONCLUSION: Study heterogeneity accounted for the variability of the results from different centers and methodological flaws such as insufficient sample size and selection bias impaired the evidence on the magnitude of BED in surgical settings. For the sake of comparability and generalizability of the findings in future studies, researchers must recruit representative samples of treatment-seeking candidates for bariatric surgery and systematically apply standard instruments for the assessment of BED.

Contributions of Emotional Overload, Emotion Dysregulation, and Impulsivity to Eating Patterns in Obese Patients with Binge Eating Disorder and Seeking Bariatric Surgery

“…More anecdotal, in our sample, the prevalence of BED was of 22.31%, which is consistent with the prevalence reported by the literature [ 36 , 37 ].…”

Bariatric and Cosmetic Surgery in People with Eating Disorders

“…The rate of current EDs in participants planning or receiving bariatric surgery was more than double that of those who had not planned or received the surgery (33.3% compared to 14.4%) and about double that of rates of EDs in the general Australian population (17.1%) [ 9 ]. The rate of lifetime BN/BED in the present study was 41.7% (over ten times the rate in the general Australian population) and this compares with clinical population samples of bariatric surgery candidates, which ranged from 6 to 64% [ 14 , 16 , 17 , 18 , 19 ]. Similarly, the rate of current EDs was 34.4% in those who were planned/actual recipients of cosmetic surgery compared to 14.6% in those not reporting this and 17.1% in the general Australian population.…”

“…With regard to the prevalence of EDs in candidates for bariatric surgery, a 2007 systematic review found that rates of BED ranged from 6 to 64%, approximately one to ten times the rate in the general population [ 14 ]. Another review found the prevalence of BED in pre-surgical patients was 2% to 53% [ 17 ]. Research on the prevalence of other EDs is scarce.…”

“…The wide range of prevalence of EDs in people undergoing surgical weight loss procedures is likely due to variable patient characteristics and ED assessment tools [17,19]. Furthermore, the existing literature has mainly studied the prevalence of BED in young females and there is a paucity of evidence regarding other populations including men and older adults and other ED features beyond binge eating [14][15][16][17][18][19][20][21][22][23][24][25]. To our knowledge, no studies have been performed on the prevalence of EDs and actual or intended bariatric surgery and cosmetic surgery in representative general population samples.…”

Comparison of plasma nucleotide metabolites and amino acids pattern in patients with binge eating disorder and obesity

“…BED is frequent in obese people; prevalence of BED in bariatric populations ranged from 2% to 53%. [3] However, many people with BED are not obese, and a large number of obese people are not afflicted by eating disorders. [4] There is currently little research on amino acids, their metabolites and nucleotide metabolites levels in eating disorders.…”