To Örebro University

The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.

Inconclusive results of how weight-loss treatment (WLT) results are affected by participants' eating disorders and/or binge eating are partly due to the variation caused by the multitude of assessment instruments used. The objective of the present study was to evaluate the psychometric properties of a short DSM-IV-based assessment instrument designed to be used specifically in WLT settings, the Eating Disorders in Obesity (EDO) questionnaire. Participants were 97 patients seeking WLT at four surgical and one non-surgical clinics. Participants were assessed by the EDO and the Eating Disorder Examination (EDE) interview . The validity and reliability of the EDO was measured as concordance with the EDE, and test-retest agreement of the EDO, respectively. Validity as well as reliability was found to be good for both eating disorders diagnoses and binge eating as a distinct symptom. Results suggest that the EDO is a short, easily administered instrument with good psychometric properties which makes it a suitable, economical method of assessing eating disorders and binge eating in clinical WLT settings.

BACKGROUND: Little is known about differences between patients in surgical and non-surgical weight-loss treatments (WLT) regarding eating disorders, level of general psychopathology, and health-related quality of life (HRQL). Such differences could indicate different clinical needs in the management of surgical compared to non-surgical WLT patients. METHODS: Participants were a subset of 100 patients from a Swedish study investigating the long-term effects of eating disorders in WLT. Participants filled out the Eating Disorders in Obesity Questionnaire as well as self-rating questionnaires of general psychopathology and HRQL before initiating surgical (n = 54) or non-surgical (n = 46) WLT. RESULTS: Eating disorders were found to be more common among patients accepted for surgical treatments, whereas binge eating (as a symptom) was found to be equally common in both groups. Surgical patients also indicated higher levels of psychopathology compared to those receiving non-surgical treatment. CONCLUSION: Patients in surgical WLT are younger, more obese, and indicate higher levels of eating disorders and psychopathology than non-surgical WLT patients. Results highlight the importance of surgical WLT units having adequate knowledge, resources, and methods for detecting and addressing issues of eating disorders and psychopathology before and during the WLT. Future longitudinal studies need to ascertain to what extent eating and general psychopathology influence the outcome of WLT in terms of lapses, complications, weight gain, quality of life, etc.

Objective Previous studies that have investigated the relationshipbetween binge eating and the long-term outcome of bariatric surgeryhave shown mixed results. Does binge eating before or after bariatricsurgery affect long-term BMI, health-related quality of life (HRQL), orpsychopathology after surgery? The objective of the present studywas to address these questions to determine the extent to whichbinge eating needs to be addressed in the context of bariatric surgeryMethods. We assessed 173 bariatric patients before and three yearsafter weight loss surgery with regard to weight, binge eating, HRQL,and psychopathology.Results. Binge eating habits before and after weight loss surgerywere unrelated to the long-term BMI outcome. Binge eating afterweight loss surgery was associated with more psychopathology and alower HRQL.Conclusion. Binge eating before or after weight loss surgery doesnot predict long-term BMI outcome. Therefore, exclusions fromsurgery for this reason alone are difficult to motivate. However,results show that binge eating after weight loss surgery is commonand is associated with both more psychopathology and a lower HRQL.The poor psychological health status of patients that binge eat afterweight loss surgery motivates studies with longer follow-up periods toinvestigate whether post-surgical binge eating might increase thevulnerability to future weight regain and complications at time pointsbeyond three years. The high rate of binge eating after surgery andits negative association with the HRQL and psychopathology indicatethat we need to be observant of the occurrence and potential effectsof binge eating in the context of bariatric surgery.