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Bariatric surgery is becoming more popular for the long-term treatment of severely obese teens. Common eating behaviors, including loss of control eating (LOC), can undermine surgical outcomes. Loss of control eating is the feeling that you cannot control what or how much you eat. There is a strong association with loss of control eating and weight gain. LOC also points to serious psychosocial complications.
Study authors previously reported that nearly 30% of teens seeking bariatric surgery experienced loss of control eating prior to surgery. However, there is very little information about its long-term course and impact on weight outcomes.
Study authors aimed to extend their previous research on presurgical loss of control eating among severely obese teens by investigating the course and outcome of loss of control eating from presurgery through a four-year follow-up.
Two types of loss of control eating were examined via a questionnaire:
1. Loss of control eating while consuming an unusually large amount of food (objective binge eating; LOC-OBE)
2. Loss of control while eating continuously (continuous loss of control eating eating; LOC-C)
At baseline, objectively large loss of control eating was reported by 15.4% of participants and continuous loss of control eating was reported by 27.8% of participants. Both forms of loss of control eating were significantly lower at all five postsurgical follow-up visits compared with presurgery (all p<.001).
Both behaviors gradually increased from six-month to four-year follow-up (ps<.05), but presurgical loss of control eating did not impact the percentage of BMI change over follow-up (p=0.72). However, study authors found that loss of control eating at one-, two- and three-year follow-up was associated with a lower percent BMI change at the next consecutive assessment (ps<.05).
Study authors observed a dramatic decrease in the occurrence of LOC eating in the period immediately after surgery, followed by gradual increases of loss of control eating over four years of postoperative follow-up.
The reporting of loss of control eating at presurgery and six-month follow-up was not predictive of later weight change, but loss of control eating at one-, two- or three-year follow-up predicted greater weight regain for teen patients. The findings indicated that loss of control eating while eating continuously is more common than binge eating after bariatric surgery.
The current study findings also contradict previous findings in teens by showing that presurgical loss of control eating had no real impact on the postsurgical BMI percentage change. However, the current study findings are consistent with most adult findings.
The study found that the rate of loss of control eating decreased from presurgery to six-months postsurgery, but increased four years after surgery. Presurgical loss of control eating had minimal impact on weight outcomes and should not preclude surgical treatment.
However, clinicians should assess and work with teen patients to manage and monitor loss of control eating in the four years after surgery since it can adversely affect long-term weight outcomes.