Psychopathology, Disordered Eating, and Impulsivity in Patients Seeking Bariatric Surgery

Abstract Background Most patients who undergo bariatric surgery experience significant weight loss and improvements in obesity-related comorbidities in the first 6-18 months after surgery. However, 20-30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. Psychosocial functioning may contribute to suboptimal weight losses and/or postoperative psychosocial distress. Setting Two university hospitals. Objective Assess psychosocial functioning, eating behavior, and impulsivity in patients seeking bariatric surgery. Methods Validated interviews and questionnaires. Impulsivity assessed via computer program. Results The present study included a larger (n = 300) and more racially diverse (70% non-white) sample than previous studies of these relationships. Forty-eight percent of participants had a current psychiatric diagnosis and 78% had at least one lifetime diagnosis. Anxiety disorders were the most common current diagnosis (25%); major depressive disorder was the most common lifetime diagnosis (44%). Approximately 6% of participants had a current alcohol or substance use disorder; 7% had a positive drug screen before surgery. A current psychiatric diagnosis was associated with greater symptoms of food addiction and night eating. Current diagnosis of alcohol use disorder or a lifetime diagnosis of anxiety disorders were associated with higher delay discounting. Conclusions The study identified high rates of psychopathology and related symptoms among a large, diverse sample of bariatric surgery candidates. Psychopathology was associated with symptoms of disordered eating and higher rates of delay discounting, suggesting impulse control issues.