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Obesity Surgery

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01-07-2018 | Original Contributions

Predictors of Binge Eating among Bariatric Surgery Candidates: Disinhibition as a Mediator of the Relationship Between Depressive Symptoms and Binge Eating

Authors: Stephanie Cox, Cassie Brode

Published in: Obesity Surgery | Issue 7/2018

Abstract

Background

Current and lifetime psychopathology is common in adult patients seeking bariatric surgery, with major depressive disorder and binge eating disorder affecting a higher proportion of this group than the general population. While depressive symptoms have been previously associated with eating pathology, potential mediators of this relationship are not well understood.

Methods

This study used a naturalistic, retrospective design to investigate cognitive and behavioral aspects of eating behavior (cognitive restraint, disinhibition, and hunger) as potential mediators of the relationship between depressive symptoms and binge eating within a sample of 119 adult patients (82.4% female; 96.6% white; mean age = 47 years) seeking bariatric surgery (Roux-en-Y and sleeve gastrectomy) at a large university medical center. Patients completed a standardized presurgical psychological evaluation to determine appropriateness for bariatric surgery as part of routine clinical practice. Binge eating was assessed via clinician rating (number of binge eating episodes per week) based on DSM-IV diagnostic criteria and self-report measures (Binge Eating Scale) in order to account for potential methodological differences. Depressive symptoms were assessed using the Beck Depression Inventory.

Results

Depressive symptoms were a significant predictor of binge eating, disinhibition, and hunger. However, only disinhibition emerged as a significant mediator of the relationship between depressive symptoms and binge eating.

Conclusions

Behavioral disinhibition, or a tendency toward overconsumption of food and challenges restraining impulses associated with a loss of control eating, may represent an important variable in determining the relation between depressive symptoms and binge eating, in bariatric surgery patients.

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. https://doi.org/10.1001/jama.292.14.1724.CrossRefPubMed

Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93. https://doi.org/10.1056/nejmoa035622.CrossRefPubMed

Hsu LK, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60(3):338–46. https://doi.org/10.1097/00006842-199805000-00021.CrossRefPubMed

Chao AM, Wadden TA, Faulconbridge LF, et al. Binge-eating disorder and the outcome of bariatric surgery in a prospective, observational study: two-year results. Obesity. 2016;24(11):2327–33. https://doi.org/10.1002/oby.21648.CrossRefPubMed

Wadden TA, Faulconbridge LF, Jones-Corneille LR, et al. Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study. Obesity. 2011;19(6):1220–8. https://doi.org/10.1038/oby.2010.336.CrossRefPubMed

Mitchell JE, Steffen K. The interface between eating disorders and bariatric surgery. Eat Disord Rev. 2009;20(1):1.

Meany G, Conceição E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev. 2014;22(2):87–91. https://doi.org/10.1002/erv.2273.CrossRefPubMedPubMedCentral

Herva A, Laitinen J, Miettunen J, et al. Obesity and depression: results from the longitudinal Northern Finland 1966 Birth Cohort Study. Int J Obes. 2005;30(3):520–7. https://doi.org/10.1038/sj.ijo.0803174.CrossRef

Telch CF, Agras WS, Rossiter EM. Binge eating increases with increasing adiposity. Int J Eat Disord. 1988;7(1):115–9. https://doi.org/10.1002/1098-108X(198801)7:1<115::AID-EAT2260070112>3.0.CO;2-W.CrossRef

10.

Linde JA, Jeffery RW, Levy RL, et al. Binge eating disorder, weight control self-efficacy, and depressive symptoms in overweight men and women. Int J Obes. 2004;28(3):418–25. https://doi.org/10.1038/sj.ijo.0802570.CrossRef

11.

Marcus MD, Wing RR, Ewing L, et al. Psychaitric disorders among obese binge eaters. Int J Eat Disord. 1990;9(1):69–77. https://doi.org/10.1002/1098-108X(199001)9:1<69::AID-EAT2260090108>3.0.CO;2-K.CrossRef

12.

Grissett NI, Fitzgibbon ML. The clinical significance of binge eating in an obese population; support for BED and questions regarding its criteria. Addict Behav. 1996;21(1):57–66. https://doi.org/10.1016/0306-4603(95)00039-9.CrossRefPubMed

13.

Mitchell JE, Selzer F, Karlarchian MA, et al. Psychopathology before surgery in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8(5):533–41. https://doi.org/10.1016/j.soard.2012.07.001.CrossRefPubMedPubMedCentral

14.

Gormally J, Black S, Daston S, et al. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7(1):47–55. https://doi.org/10.1016/0306-4603(82)90024-7.CrossRefPubMed

15.

(2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

16.

Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985;29(1):71–83. https://doi.org/10.1016/0022-3999(85)90010-8.CrossRefPubMed

17.

Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6. https://doi.org/10.1016/j.soard.2008.04.013.CrossRefPubMedPubMedCentral

18.

Kalarchian MA, Marcus MD, Wilson GT, et al. Binge eating among gastric bypass patients at long-term follow-up. Obes Surg. 2002;12(2):270–5. https://doi.org/10.1381/096089202762552494.CrossRefPubMed

19.

Ricciardelli LA, Tate D, Williams RJ. Body dissatisfaction as a mediator of the relationship between dietary restraint and bulimic eating patterns. Appetite. 1997;29(1):43–54. https://doi.org/10.1006/appe.1997.0093

20.

Ashton K, Drerup M, Windover A, et al. Brief, four-session group CBT reduces binge eating behaviors among bariatric surgery candidates. Surg Obes Relat Dis. 2009;5(2):257–62. https://doi.org/10.1016/j.soard.2009.01.005.

21.

Beck AT, Steer RA, Brown GK. Manual for the Beck Depressive symptoms Inventory-II. San Antonio, TX: Psychological Corporation; 1996.

22.

Hayden MJ, Brown WA, Brennan L, et al. Validity of the Beck Depression Inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates. Obes Surg. 2012;22(11):1666–75. https://doi.org/10.1007/s11695-012-0682-4.

23.

Marek RJ, Heinberg LJ, Lavery M, et al. A review of psychological assessment instruments for use in bariatric surgery evaluations. Psychol Assess. 2016;28(9):1142–57. https://doi.org/10.1037/pas0000286.

24.

Hall BJ, Hood MM, Nackers LM, et al. Confirmatory factor analysis of the Beck Depression Inventory-II in bariatric surgery candidates. Psychol Assess. 2013;25(1):294–9. https://doi.org/10.1037/a0030305.CrossRefPubMed

25.

Allison DB, Kalinsky LB, Gorman BS. A comparison of the psychometric properties of three measures of dietary restraint. Psychol Assess. 1992;4(3):391–8. https://doi.org/10.1037/1040-3590.4.3.391.CrossRef

26.

Kalarchian MA, Wilson GT, Brolin RE, et al. Binge eating in bariatric surgery patients. Int J Eat Disord. 1998;23(1):89–92. https://doi.org/10.1002/(SICI)1098-108X(199801)23:1<89::AID-EAT11>3.0.CO;2-I.CrossRefPubMed

27.

Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research—conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82. https://doi.org/10.1037/0022-3514.51.6.1173.CrossRefPubMed

28.

Colles SL, Dixon JB, O’Brien PE. Loss of control is central to psychological disturbance associated with binge eating disorder. Obesity. 2008;16(3):608–14. https://doi.org/10.1038/oby.2007.99.CrossRefPubMed

29.

Hsu LKG, Mulliken B, McDonagh B, et al. Binge eating disorder in extreme obesity. Int J Obes Relat Metab Disorders. 2002;26(10):1398.CrossRef

30.

Bergman K, Cox S, Tabone LT. The influence of a rural environment on patient access and outcomes for bariatric surgery. Surg Obes Relat Dis. 2017;11(6)

31.

Skinner HH, Haines J, Austin SB, et al. A prospective study of overeating, binge eating, and depressive symptoms among adolescent and young adult women. J Adolesc Health. 2012;50(5):478–83. https://doi.org/10.1016/j.jadohealth.2011.10.002.CrossRefPubMed

Title: Predictors of Binge Eating among Bariatric Surgery Candidates: Disinhibition as a Mediator of the Relationship Between Depressive Symptoms and Binge Eating
Authors: Stephanie Cox
Cassie Brode
Publication date: 01-07-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 7/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-018-3129-8

At a glance: The STEP trials

Springer Medicine

Predictors of Binge Eating among Bariatric Surgery Candidates: Disinhibition as a Mediator of the Relationship Between Depressive Symptoms and Binge Eating

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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