Self-Reported Eating Disorder Symptoms Before and After Gastric Bypass and Duodenal Switch for Super Obesity - a 5-Year Follow-Up Study.

Abstract

Background This study assessed eating disorder pathology in persons with obesity before and after Roux-en-Y gastric by- pass (RYGB) and biliopancreatic diversion with duodenal switch (DS), in a 5-year follow-up study. Methods Sixty participants with BMI 50 – 60 kg/m 2 were ran- domly assigned to RYGB ( n =31) or DS ( n =29). The partic- ipants completed the Eating Disorder Examination- Questionnaire (EDE-Q) before and 6 months, 1 year, 2 years, and 5 years after surgery. Results Before surgery, the prevalence of objective bulimic episodes was 29 % in the RYGB group and 32 % in the DS group. The prevalence improved during the first 12 months after surgery in both groups. After 5 years, the prevalence of objective bulimic episodes was 22 % in the RYGB group and 7 % in the DS group. The difference between groups through- out follow-up was non-significant (logistic regression model). A linear mixed model showed that global EDE-Q score was not a significant predictor for weight loss after surgery, but participants reporting objective bulimic episodes before sur- gery had significantly lower BMI than those with no episodes after 2 years ( p =0.042) and 5 years ( p =0.013). Global EDE-Q score was significantly lower in the DS group after 5 years ( p =0.009) (linear mixed model). Conclusions Objective bulimic episodes but not global EDE- Q score before surgery predicted greater weight loss after RYGB and DS. The DS group had a significantly lower global EDE-Q score than the RYGB group 5 years after surgery.