Binge eating before and after bariatric surgery

Background - Obesity is a complex, multifactorial disorder which comprises psychological, social and biological aspects and requires a multidisciplinary approach. It is considered to be a risk factor for binge eating disorder, in that the emotional dynamic of the obese individual would contribute to trigger the compulsive act. Aim - To analyze the signs of binge eating in patients who underwent bariatric surgery, before and two years after the surgery. Methods - A prospective study was conducted with 50 patients submitted to bariatric surgery by the Fobi-Capella technique. The instruments for psychological evaluation, applied before the surgery and two years after, were Max Pfister's Color Pyramid Test and a semi-structured clinical interview. The test was given before and after the surgery to identify evidence of compulsive behavior. The interview was conducted in the postoperative only. Results - The data showed stability and ability to cope with conflicts in 16% of the patients before and in 10% after the surgery. In terms of control and adaptation, 36% of the patients exhibited strong evidence of an attitude of control and rigidity before the surgery, and 32% postoperatively. Regarding the indicators of impulsivity, agressiveness and irritability, there were strong signs of aggressive and impulsive attitudes in 28% of the patients before the surgery and in 36% after. Grazing behavior was present in 94% of the patients preoperatively and in 60% postoperatively. Food preference was for high-calorie foods with no mention of alcoholic beverages in preoperative patients, and postoperatively, for foods which were easy to consume. Regarding the reason for the compulsive episodes, before the surgery, 4% of the patients reported uneasiness, 24% expressed mood disturbances and 52% identified feelings of impotence or submission. Postoperatively, the percentages were 10%, 28% and 38%, respectively. As for compensatory responses, they consisted of the ingestion of sweet foods in 12%, snack foods in 2% and indiscriminate eating in 64% of the patients. After the surgery, the percentages were18%, 10% and 22%. Conclusion - The patients exhibit signs of binge eating before and after the surgery. Such compulsion is related to psychological aspects. Eating habits and food preferences change after the surgery, as patients begin to eat foods which are easier to consume when facing situations that would make them eat compulsively; no addiction transfer was observed. The inadequate eating behavior persists or is aggravated after the surgery.