Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy.

Stephanie Cassin,Sanjeev Sockalingam,Raed Hawa,Susan Wnuk,Samantha Leung,Timothy Jackson

doi:10.3390/nu12102905

Abstract

The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample.

Highlights

The increasing prevalence of obesity is a growing global concern [1]
The current study examining the correlates of food addiction and changes in food addiction in response to cognitive behavioural therapy was part of a larger multisite randomized controlled trial
“diagnosis” for food addiction at 1 year post-surgery was included in the data analyses for the third study aim

Summary

Introduction

Bariatric surgery remains the most durable intervention for severe obesity, with studies demonstrating significant weight loss and improvements in, or even resolution of, obesity-related comorbidities [2,3,4]. The period of most significant weight loss occurs within the first 12 months following surgery [5,6]; between. Weight change trajectories begin to diverge between 6 and 12 months following surgery [5,6] and different trajectories have an impact on the prevalence of comorbidities and corresponding health care. Post-operative binge eating, loss of control eating, and grazing have been shown to predict poorer weight loss outcomes following surgery [11,12,13]. The concept of food addiction (FA) may help account for the divergent weight change trajectories observed following bariatric surgery. It has been proposed that certain foods (i.e., hyperpalatable foods with refined carbohydrates and/or added fats) share pharmacokinetic properties with drugs of abuse [14], and are capable of activating an addictive-like process in susceptible individuals that can cause weight-promoting eating behaviours such as compulsive overeating and binge eating [15]

Methods

Results

Conclusion