In the Journals

‘Overvaluing’ weight hampers dietary, psychological benefits of bariatric surgery

Recipients of bariatric surgery who “overvalue” their weight are more likely to experience loss-of-control eating, eating disorders and depressive symptoms than those who do not put as much emphasis on their weight, according to findings published in Obesity.

“Both disordered eating and loss-of-control eating have been associated with poorer long-term weight outcomes after surgery,” Valentina Ivezaj, PhD, an assistant professor in the department of psychiatry at Yale School of Medicine, and colleagues wrote. “Emerging evidence has suggested that careful attention during the postoperative period is warranted, as problematic eating behaviors might hinder weight loss.”

Ivezaj and colleagues used questionnaires to assess loss-of-control eating frequency, weight and shape evaluation, depressive symptoms and self-reported function in 145 recipients of sleeve gastrectomy surgery (mean age, 45.4 years; 82.8% women). Surgeries were performed at Yale Bariatric/Gastrointestinal Surgery Center of Excellence within 6 months of study initiation, according to the researchers.

Fifty-one percent of the participants met the standards for clinical overvaluation, which was defined by a score of at least 4 on a 6-point scale from the Eating Disorder Examination-Bariatric Surgery Version interview. According to the researchers, the average number of loss-of-control eating events in the previous 28 days was higher for those with clinical overvaluation compared with those with subclinical levels (25.01 vs. 17.96; P = .017). The researchers also noted that the average score on the Beck Depression Inventory-Second Edition fell within the range for mild depression for those who overvalued (14.21) while the average score for those who did not was more in line with minimal depressive symptoms (9.76; P = .012). Those who overvalued their weight reported higher scores on the Sheehan Disability Scale for weight (19.24 vs. 12.16; P = .041) and eating (17.24 vs. 7.68; P = .015) compared with those who did not overvalue. In addition, binge eating disorder was identified in 63.8% of those who overvalued and in 36.2% of those who did not (P = .007) based on answers to the Mini-International Psychiatric Interview.

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Recipients of bariatric surgery who “overvalue” their weight are more likely to experience loss-of-control eating, eating disorders and depressive symptoms than those who do not put as much emphasis on their weight.
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Overall, there were associations between overvaluing weight and loss-of-control eating events (P = .006), as well as scores on the questionnaires for eating disorders (P < .0005), depressive symptoms (P < .005), function related to weight (P < .0005) and function related to eating (P < .0005), the researchers wrote.

“Our findings suggest that overvaluation of weight or shape is a useful signal for broader levels of impairment,” the researchers wrote. “Improved understanding of overvaluation among this patient group may help inform treatment needs of patients struggling with disordered eating and associated features following bariatric surgery.” – by Phil Neuffer

Disclosures: Ivezaj reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Recipients of bariatric surgery who “overvalue” their weight are more likely to experience loss-of-control eating, eating disorders and depressive symptoms than those who do not put as much emphasis on their weight, according to findings published in Obesity.

“Both disordered eating and loss-of-control eating have been associated with poorer long-term weight outcomes after surgery,” Valentina Ivezaj, PhD, an assistant professor in the department of psychiatry at Yale School of Medicine, and colleagues wrote. “Emerging evidence has suggested that careful attention during the postoperative period is warranted, as problematic eating behaviors might hinder weight loss.”

Ivezaj and colleagues used questionnaires to assess loss-of-control eating frequency, weight and shape evaluation, depressive symptoms and self-reported function in 145 recipients of sleeve gastrectomy surgery (mean age, 45.4 years; 82.8% women). Surgeries were performed at Yale Bariatric/Gastrointestinal Surgery Center of Excellence within 6 months of study initiation, according to the researchers.

Fifty-one percent of the participants met the standards for clinical overvaluation, which was defined by a score of at least 4 on a 6-point scale from the Eating Disorder Examination-Bariatric Surgery Version interview. According to the researchers, the average number of loss-of-control eating events in the previous 28 days was higher for those with clinical overvaluation compared with those with subclinical levels (25.01 vs. 17.96; P = .017). The researchers also noted that the average score on the Beck Depression Inventory-Second Edition fell within the range for mild depression for those who overvalued (14.21) while the average score for those who did not was more in line with minimal depressive symptoms (9.76; P = .012). Those who overvalued their weight reported higher scores on the Sheehan Disability Scale for weight (19.24 vs. 12.16; P = .041) and eating (17.24 vs. 7.68; P = .015) compared with those who did not overvalue. In addition, binge eating disorder was identified in 63.8% of those who overvalued and in 36.2% of those who did not (P = .007) based on answers to the Mini-International Psychiatric Interview.

#
Recipients of bariatric surgery who “overvalue” their weight are more likely to experience loss-of-control eating, eating disorders and depressive symptoms than those who do not put as much emphasis on their weight.
Adobe Stock

Overall, there were associations between overvaluing weight and loss-of-control eating events (P = .006), as well as scores on the questionnaires for eating disorders (P < .0005), depressive symptoms (P < .005), function related to weight (P < .0005) and function related to eating (P < .0005), the researchers wrote.

“Our findings suggest that overvaluation of weight or shape is a useful signal for broader levels of impairment,” the researchers wrote. “Improved understanding of overvaluation among this patient group may help inform treatment needs of patients struggling with disordered eating and associated features following bariatric surgery.” – by Phil Neuffer

Disclosures: Ivezaj reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.