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Objective: To investigate the influence of dieting and of body shape dissatisfaction on binge eating., Design: Longitudinal study following billiopancreatic diversion (BPD), when the body shape has become normal or nearly normal, and any worries over weight, dieting and food have probably been abandoned completely., Subjects: 65 severely obese patients, evaluated by clinical semistructured interview for occurrence of binge eating episodes prior to, and at one and at two years following BPD., Results: Whereas preoperative binge eating had been reported by 65% of the obese individuals, at two years following BPD binge eating occurred only in 9.2% of them., Conclusions: Weight stabilisation following BPD is associated with a sharp improvement in control over food intake, and this suggests the central role of dieting and/or of body dissatisfaction in causing binge eating episodes. more...

Food- and weight-related attitudes were assessed in obese subjects prior to biliopancreatic diversion (BPD) and at 1 and 2 years after BPD, when any preoccupation with dieting and body weight and shape should have been abandoned. A decrease in the number of subjects whose food attitudes suggested some loss of control over food consumption, such as snacking, nibbling, getting hungry and eating in response to non-alimentary stimuli or arousal conditions was observed, confirming the role of dieting in leading to loss of control over food intake. The stable weight loss correlated with changes in the body attitudes and in the overall psychological status. The changes observed in obese persons after BPD suggest that 1) the food-related attitudes are influenced by the preoccupation with food and with dieting; 2) the weight-related attitudes are accounted for more by dissatisfaction with a body shape that is very different from the socially accepted one than by an individual's psychological traits. more...

The relationships between the cognitive restraint and the tendency to disinhibition prior to gastric banding for obesity, as assessed by the Three Factor Eating Questionnaire, and the weight loss at one year following the operation were investigated. The amount of overall weight loss was correlated positively to the disinhibition and negatively to the cognitive restraint score. When the food consumption overtakes the proximal gastric pouch capacity, the patient feels a strong aversive stimulus, thus stopping eating. Therefore, more is the patient's tendency to lose the control on food intake more is the postoperative weight loss. On the contrary, the high restraint patient only seldom feels such an aversive stimulus, and only seldom stops eating, thus the weight loss is smaller. Except for the overeating due to the disinhibition, the aversive stimulus arising from the gastric restriction cannot influence by itself any other aspect of eating behavior. more...

Data on the prevalence of binge eating in a series of 92 massively obese patients undergoing bariatric surgery are presented. A semistructured clinical interview demonstrated that 63 individuals had problems with binge eating, 43 of these reporting episodes of binge eating more than twice a week and then meeting the diagnostic criteria for binge eating disorder. By comparison with their nonbinge eating counterparts, binge eaters demonstrated higher body weight, greater weight fluctuation due to reducing diets in their past lifetime, higher Three-Factor Eating Questionnaire Disinhibition and Hunger score, and an overall higher psychopathology as assessed by the Eating Disorder Inventory. The great prevalence of binge eating in these patients could be accounted for by the high body weight, by the characteristics of the patients, or by the context in which the eating behavior assessment was carried out. more...

The relationships between the resting energy expenditure (REE), measured by indirect calorimetry, and eating behavior, assessed by the "Three Factor Eating Questionnaire" were evaluated. The study was carried out in a group of healthy never-obese subjects and in two groups of formerly obese people, who have maintained a normal weight for more than two years. The subjects of the first formerly obese group had brought their body weight to normal by dieting. The second one comprised subjects following biliopancreatic diversion for obesity (BPD) in the long term, who maintain a normal weight because of the intestinal malabsorption due to the operation regardless of food consumption. In comparison with the other subjects, significantly higher cognitive restraint score values were observed in the post-diet subjects. Furthermore, a negative significant correlation between cognitive restraint and REE was found in the non operated subjects, while such correlation was not present in the BPD subjects. Therefore, in normal people cognitive restraint has to be considered to be related to behavioral-cognitive factors rather than biologically driven by energy requirements. more...

The eating behavior of obese patients and of subjects who had normalized their body weight following biliopancreatic diversion (BPD) was assessed by a three-factor eating questionnaire (TFEQ), constructed to measure cognitive dietary restraint, the tendency to disinhibition, and susceptibility to hunger. In the obese patients higher values of both disinhibition and hunger score were found than in normoweight persons. In BPD subjects a negative association between the time elapsed from the operation and both the disinhibition and hunger score values was observed. In patients operated more than 2 years before, the eating behavior, as assessed by the TFEQ, was similar to that of normoweight persons. After BPD the operated subjects do not have to respect any dietary advice, the loss of weight and the maintenance of a normal body weight occurring in spite of an absolutely free food consumption. Similarity to the control values of disinhibition and hunger score following BPD suggests that in the long term, when the preoccupation with food and diet is abandoned, a normal eating pattern can be achieved. more...