Chronic Dieting Among Extremely Obese Bariatric Surgery Candidates
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Extremely obese bariatric surgery candidates report numerous episodes of both successful and unsuccessful dieting attempts, but little is known about the clinical significance of frequent dieting attempts in this patient group.
The current study examined psychological and weight-related correlates of self-reported dieting frequency in 219 bariatric surgery candidates (29 men and 190 women). Prior to surgery, patients completed a battery of established self-report assessments. Patients were dichotomized into chronic dieters (n = 109) and intermittent dieters (n = 110) based on a median split of self-reported percent time spent dieting during adulthood. The two dieting groups were compared on demographics, eating and weight history, eating disorder psychopathology, and global functioning.
Chronic dieters had significantly lower pre-operative body mass indexes (BMIs), lower highest-ever BMIs, more episodes of weight cycling, and earlier ages of onset for overweight and dieting than intermittent dieters. After controlling for differences in BMI, chronic dieters were found to have statistically but not clinically significant elevations in eating concerns, dietary restraint, and body dissatisfaction than infrequent dieters. The two groups, however, did not differ significantly on depressive symptoms, self-esteem, or health-related quality of life; nor did they differ in binge-eating status.
Chronic dieting is commonly reported among extremely obese bariatric candidates and is not associated with poorer psychological functioning or binge eating and may be beneficial in attenuating even greater weight gain. Our findings provide preliminary data to suggest that requiring additional presurgical weight loss attempts may not be warranted for the vast majority of extremely obese bariatric candidates.
KeywordsDieting Psychological functioning Eating pathology Weight history Insurance prerequisites
The authors were supported by grants from the National Institutes of Health (K24 DK070052, K23 DK071646, R01 DK49587, R01 DK073542, and R21 MH077290). No additional funding was received for the completion of this work. The authors have no conflicts of interest, financial or otherwise, that are relevant for this submitted work.
- 13.MB KL, Horbach T, Teske V, et al. Assessment of eating disorder psychopathology in pre-gastric banding candidates: interview or self-report? Psychother Psychosom Med Psychol. 2007;57:237–241.Google Scholar
- 19.Beck AT, Steer R. Manual for Revised Beck Depression Inventory. New York: Psychological Corporation; 1987.Google Scholar
- 23.Krukowski RA, Friedman KE, Applegate KL. The utility of the Beck Depression Inventory in a bariatric surgery population. Obes Surg. 2009 Oct 8 (in press).Google Scholar
- 24.Rosenberg M. Conceiving the self. New York: Basic Books; 1979.Google Scholar
- 29.Ware JE Jr, Kosinski M, Keller SD. SF-36 Physical and Mental Health Summary Scales -- A User's Manual. Boston: New England Medical Center, The Health Institute; 1994.Google Scholar
- 30.American Psychiatric Association. Diagnostic and Statistical Manual - Text Revision. Washington, DC: American Psychiatric Association; 2000.Google Scholar
- 32.Wilson GT. The controversy over dieting. In: Fairburn CG, Brownell KD, editors. Eating Disorders and Obesity. New York: Guilford Press; 2005. p. 93–97.Google Scholar
- 40.Bellisle F, Clement K, Le Barzic M, et al. The eating inventory and body adiposity from leanness to massive obesity: a study of 2509 adults. Obesity (Silver Spring). 2004;12:2023–2030.Google Scholar