Problematic eating behaviors after bariatric surgery: A national study with a Portuguese sample

Abstract

Introduction: Bariatric surgery is the most effective method for the treatment of morbid obesity. However, the development of eating psychopathology and the emergence of problematic eating behaviours have been reported in the literature. The aim of this cross-sectional study was to characterize the post-bariatric population in terms of the frequency of problematic eating behaviours over time and to understand the related psychological features. Material and Methods: This sample was composed of 155 bariatric patients that responded to several self-reported instruments assessing eating psychopathology, problematic eating behaviours, anxiety, depression and stress and impulsive behaviour. Results: Results showed that grazing, binge eating, concerns about body weight and shape, and negative urgency are significantly more frequent at 24 months after bariatric surgery (when compared to earlier postoperative assessments). Correlational analyses showed that eating psychopathology and problematic eating behaviours were significantly and positively associated with levels of anxiety, depression, stress and negative urgency. This study also reinforces the mediating role of negative urgency in the relationship between time elapsed since surgery and psychological distress, and problematic eating behaviours, accounting for a total of 32.3% and 27.2% of its variance, respectively. Discussion: The results suggest a growing trend of problematic eating behaviours and levels of impulsivity being reported by bariatric patients over time. Conclusion: Given the established evidence that supports its impact on weight variability, early identification of problematic eating behaviours and of patients with a tendency to act impulsively in situations of negative emotionality should be a central concern in the follow-up of the bariatric population.