Real-time versus retrospective self-report assessment of loss-of-control eating in adults undergoing bariatric surgery.

Abstract

Loss-of-control (LOC) eating is common in adults undergoing bariatric surgery. Agreement between real-time and retrospective assessment methods is unclear. Adults with severe obesity reported on LOC eating over the preceding 28 days via Eating Disorder Examination-Questionnaire (EDE-Q) items and in near real time over 10 days via ecological momentary assessment (EMA; involving daily repeated surveys delivered via smartphone in the natural environment), with both assessment forms completed before surgery and at 3, 6, and 12 months after surgery. Wilcoxon signed rank tests and generalized linear mixed models were used to compare participants' EDE-Q and EMA reports of subjectively and objectively large LOC episodes across time points. Participants reported subjectively large LOC episodes more frequently via EMA than EDE-Q across time points, although differences did not reach statistical significance (all p > 0.05). Conversely, objectively large LOC episodes were more frequently reported via EDE-Q than EMA, with differences reaching significance at 6 months post surgery only (p=0.03). Agreement between real-time and retrospective assessments of LOC eating varied by episode size and time elapsed in the year following surgery. These findings should be considered when designing assessment batteries for bariatric surgery-seeking adults and when extrapolating research findings across studies with diverging methods of real-time versus retrospective self-report assessment of LOC eating in adults undergoing bariatric surgery.