Racial differences after bariatric surgery: 24-month follow-up of a randomized, controlled trial for postoperative loss-of-control eating

Background: While some bariatric surgery outcomes vary by race/ethnicity, less is known about racial/ethnic differences in loss-of-control (LOC) eating and psychosocial outcomes post-surgery. Objective: This prospective study examined and extended initial short-term findings regarding racial differences in post-bariatric surgery LOC eating and weight loss to longer-term outcomes through 24-month follow-ups. Setting: Academic medical center in the United States. Methods: Participants were 140 patients (46.4% non-White) in a 3-month randomized, controlled trial for LOC eating performed about 6 months after bariatric surgery. Participants were reassessed at 6, 12, 18, and 24 months after treatment ended (about 33 mo after surgery). Doctoral assessors administered the Eating Disorder Examination-Bariatric Surgery Version interview to assess LOC eating and eating-disorder psychopathology at 12- and 24-month follow-ups. The Beck Depression Inventory II was repeated, and measured weight was obtained at all follow-ups. Results: White patients had significantly greater percent excess weight loss at all follow-ups than nonWhite patients (p < .03). White patients reported significantly more LOC eating at 12- (p = .004) and 24-month (p = .024) follow-ups and significantly greater eating disorder psychopathology at 12-month follow-up (p < .028). Racial groups did not differ significantly in eating disorder psychopathology at 24-month follow-ups or in Beck Depression Inventory II depression scores at any follow-ups. Conclusions: Our findings suggest that among patients with LOC eating after bariatric surgery, nonWhite patients attain a lower percent excess weight loss than White patients but have comparable or better outcomes in LOC eating, associated eating disorder psychopathology, and depression over time.