Weight Loss Surgery

Significant Reductions in Binge Eating Occur After Weight Loss Surgery

July, 18, 2012

Binge eating disorder is the most common eating disorder in the United States and is prevalent in up to 30% of those seeking weight loss surgery. Its prevalence in the population, at large, is eight percent. It can have an exclusive night eating or nocturnal component for some patients. It generally leads to obesity, can have a genetic component, and also tends to be more common in women. Childhood obesity can be a risk factor. Usually the foods eaten are “comfort” foods. It is important to note that bingeing episodes can lead to a lack of proper nutrition; many of the “comfort” foods involved in binging can be high in fat, sugar and/or salt, but low in vitamins and minerals.

Signs of binge eating disorder may include:

• Loss of control over eating during a binge
• Eating large amounts of food and quickly
• Eating when depressed, lonely or bored
• Experiencing shame after binge eating

Currently, the DSM-IV (Psychiatric Manual) categorizes binge eating under Eating Disorder Not Otherwise Specified. It is included as a diagnostic category for further study in DSM-IV to have more specific diagnostic criteria.

Treatment options include psychotherapy, overeaters anonymous meetings and other support modalities. Supportive and cognitive behavioral therapy can be very helpful, therapy in particular helps people track their feelings and behaviors towards food. Developing alternatives to stop emotional overeating is key to success such as exercise, reaching out to friends for support, recreational games, reading, listening to music and various other hobbies.

In addition, helpful tips to stop overeating include:

• Slow down, and pause in between bites. The slower you eat, the more time your body has to catch up and tell you that you are full.
• Set your utensil down in between bites. Allow yourself to fully chew your food.
• Make it a habit to sit at a table and eat.
• Don’t eat while cooking. Tasting foods can add a lot of extra calories.
• Drink plenty of water.

For many patients who are obese, weight loss surgery can be a viable option. Bariatric surgery is effective in producing weight loss and abstinence in severely obese binge eating disorder. Significant reductions in binge eating usually occur after obesity surgery in patients. In one study, binge eating was eliminated in all of 22 patients classified pre-surgically as binge eaters at a four-month-follow-up, post-surgery.

Whether obesity leads to psychopathology, perhaps through discrimination and isolation or psychopathology leads to obesity, the etiologies are multifaceted and are not clear. We need more research to learn about binge eating disorder and ways to help patients cope better with emotional stress, loneliness and boredom. Obesity is a national crisis and various treatment options, including weight loss surgery, can help.