Preoperative Binge Eating and Weight Loss After Bariatric Surgery: A Systematic Review and Meta-analysis
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Preoperative Binge Eating and Weight Loss After Bariatric Surgery: A Systematic Review and Meta-analysis Natália Luiza Kops 1 & Manoela Astolfi Vivan 2 & Elisa Ruiz Fülber 2 & Marco Fleuri 2 & Julia Fagundes 2 & Rogério Friedman 1,3 Received: 11 July 2020 / Revised: 10 November 2020 / Accepted: 11 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Several studies have investigated if bariatric surgery candidates with binge eating disorder (BED) are at risk for suboptimal postoperative weight loss. The aim of this systematic review with meta-analysis was to evaluate the association between binge eating diagnosed preoperatively and weight loss after bariatric surgery. Methods MEDLINE, EMBASE, CENTRAL, LILACS, and other specialized databases were searched on August 2020. Clinical trials and observational studies including individuals who had undergone any type of bariatric surgical treatment with preoperative evaluation of BED and at least one postoperative measure of weight were initially selected. Four reviewers independently screened for eligibility. The mean difference was calculated using the random-effects model. Results Nineteen studies, comprising 3223 participants (80.25% women; median age 41 years), met the inclusion criteria for meta-analysis. At 6 months postoperative, the percentage of total weight loss (%TWL) was not significantly different between BED and non-BED groups [6 studies, 914 participants: − 0.75% (95% CI, − 2.79 to 1.29; I2 = 0%)], even when analyzing only those three studies that included gold standard assessment tools. No significant differences were found at 12, 24, 36, or 60 months. Conclusions Pre-bariatric BED seems to have little or no influence on weight loss after surgery. However, many questions remain unanswered because of the use of different measures across studies. The heterogeneity among studies emphasizes the importance of investigators using the same assessment measures. Keywords Binge eating disorder . Eating disorders . Bariatric surgery . Weight loss . Meta-analysis
Introduction Several studies have examined psychological factors and weight change after bariatric surgery due to their important role in maintaining surgically induced weight loss [1–4]. The prevalence of eating disorders is even higher in individuals undergoing weight
reduction surgery than in the general population [5, 6], and binge eating disorder (BED) is the second most common single disorder, occurring in 17% of patients [7]. Guidelines recommend a multidisciplinary assessment of bariatric surgery candidates to identify potential psychological factors that may compromise surgery outcomes [8]. However,
* Natália Luiza Kops [email protected] Manoela Astolfi Vivan [email protected]
Rogério Friedman [email protected] 1
Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul 90560-030, Brazil
2
Federal University of Rio Grande do Sul (UFRGS), Porto
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