Binge eating in the bariatric surgery population: A review of the literature

Objective: This article reviews the status of the literature addressing clinically significant binge eating in the bariatric surgery patient. The goal is to provide a background that will guide patients, surgeons, and mental health practitioners toward the most successful long-term surgical outcome when binge eating is identified. Method: Pubmed and Medline search with subsequent reference list search of identified articles. We searched literature through April 2006 on the influence of binge eating (BE) on surgical outcome. Results: Those with pre-surgical BE are more likely to retain the eating pathology and, if they do, to have poorer weight loss outcome. Many people who binge ate prior to surgery report continued feelings of loss of control when eating small amounts of food after surgery. Studies that employed the DSM-IV definition of a binge episode reported absence of BE after surgery, unlike those that modified binge criteria after surgery. Conclusion: Clinically significant BE is related to poorer surgical outcomes, and additional interventions may be needed to improve long term outcomes. Though surgery does alter body's physiology, claims that the psychological aspects of BE are "cured" by obesity surgery must be viewed with caution. Researchers and practitioners must reach a consensus on how to define BE after gastric surgery so that future long-term prospective studies may further evaluate the effect of BE on surgical outcome and vice versa.