Eating habits can thwart weight-loss surgery

Obese people prone to binge eating may be less likely to have a successful outcome after weight-loss surgery, research suggests. Exercise habits, however, had relatively little effect.

In a study of 157 severely obese adults who underwent gastric-banding surgery, Dutch researchers found that those exhibiting either "emotional" or "external" eating were more likely to binge in the months to years following surgery.

Emotional eating refers to the tendency to eat according to mood rather than hunger, while people prone to external eating often overeat in response to the sight or smell of food, regardless of their actual hunger.

The new findings suggest that helping people manage these problems might improve their outcomes after weight-loss surgery, Dr. Junilla K. Larsen, the study's lead author, told Reuters Health.

She and her colleagues at Radboud University Nijmegen and Utrecht University in the Netherlands report the findings in the International Journal of Eating Disorders.

All of the study patients had undergone gastric banding, a form of obesity surgery in which a band is placed around the upper portion of the stomach to form a small pouch that holds only a small amount of food at a time. Though this makes it hard to binge, past studies have found such eating habits to be a problem after surgery.

After gastric banding, for example, some people regain weight by overeating high-calorie soft foods that pass more easily through the small opening to the stomach.

In an earlier study, Larsen's team found that about one-third of patients had problems with binge eating after gastric banding, and they tended to lose less weight and have poorer mental health.

The current study sought to pinpoint the general eating patterns that make post-surgery bingeing more likely, with both emotional and external eating emerging as culprits.

Such eating patterns can be identified fairly simply; the current study used a standard questionnaire called the Dutch Eating Behavior Questionnaire, Larsen noted.

Future studies, Larsen said, should look at whether screening for emotional and external eating, and then helping patients manage the habits, can improve the odds of post-surgery success.

SOURCE: International Journal of Eating Disorders, July 2006.