Chapter 47 - Control Eating Following Bariatric Surgery

Abstract

Eating behaviors have been associated with weight- and psychological-related outcomes of surgery. This chapter describes different eating behaviors associated with the experience of loss of control (LOC) overeating in the postoperative bariatric population. A few considerations should be taken into account when assessing eating behaviors in the postoperative time. Bariatric surgery induces a great alteration in the gastric tract, and the amount of food that postbariatric patients can accommodate is greatly limited. Thus, diagnostic criteria for binge eating disorder (BED), which requires the ingestion of unambiguously large amounts of food accompanied by the sense of LOC overeating, is rare in the postoperative time. Despite lower rates of BED, postbariatric patients still engage is binge eating (BE) episodes over amounts of food that are not unambiguously large, but are experienced as excessive. The experience of LOC, regardless of how much and what is eaten, has been considered the hallmark feature of BE for its association with poor weight loss, high food avoidance, restraint eating, hunger, maturity fears, perfectionism, and other eating-related psychopathological features. Additionally, other forms of LOC eating have been identified and also associated with poor outcomes. Grazing, generally characterized by repetitive eating of small/modest amounts of food in an unplanned manner, is another eating behavior that has been associated with some degree of LOC eating. Assessment measures for the postoperative samples should capture subsyndromal presentations of BED and the experience of LOC eating regardless of the amount ingested.