Nearly five percent of Americans now suffer from extreme obesity, defined by a body mass index (BMI) >= 40 kg/m 2. This condition is associated with dire health and economic consequences that make weight reduction imperative. Bariatric surgery is the most effective intervention for extreme obesity and will be sought this year by approximately 125,000 individuals. The gastric bypass (GBP) reduces initial body weight by an average of 25 percent to 30 percent; however, treatment outcome is variable. A substantial minority of individuals fails to achieve significant weight loss, and even more regain weight two or more years after surgery. As a result, leading bariatric surgeons recommend that surgical candidates undergo a behavioral (psychiatric) evaluation to identify those with psychosocial contraindications. There are few data, however, to inform patient selection or the need for postoperative counseling. Binge eating disorder (BED) is common among extremely obese individuals and is arguably the most likely behavioral complication to affect the outcome of bariatric surgery. BED is characterized by the consumption of an objectively large amount of food and the experience of loss of control during overeating episodes. It also is associated with increased symptoms of depression and other psychopathology. The proposed research will address critical gaps in our knowledge concerning whether binge eating disorder negatively affects the outcome of GBP, either by limiting weight loss or by increasing the rate of postoperative behavioral complications (including vomiting and dumping). These findings should guide patient selection and the provision of postoperative counseling. The study, in turn, will reveal the effects of GBP on binge eating, energy and macronutrient intake, appetite, and physical activity. Changes over 30 months in patients with (N = 80) and without BED (N = 80) will be compared with each other but also with changes in a group of comparably obese individuals with BED who are treated by a traditional behavioral weight control program. Inclusion of this latter group (N = 50) will more fully reveal the behavioral risks and benefits of GBP. The study, by examining ghrelin and other appetite-related hormones, also will enhance knowledge of the regulation of body weight following GBP.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
1R01DK069652-01
Application #
6855936
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Miles, Carolyn
Project Start
2005-01-01
Project End
2009-12-31
Budget Start
2005-01-01
Budget End
2005-12-31
Support Year
1
Fiscal Year
2005
Total Cost
$324,925
Indirect Cost
Name
University of Pennsylvania
Department
Psychiatry
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Chao, Ariana M; Wadden, Thomas A; Faulconbridge, Lucy F et al. (2016) Binge-eating disorder and the outcome of bariatric surgery in a prospective, observational study: Two-year results. Obesity (Silver Spring) 24:2327-2333
Faulconbridge, Lucy F; Wadden, Thomas A; Thomas, John G et al. (2013) Changes in depression and quality of life in obese individuals with binge eating disorder: bariatric surgery versus lifestyle modification. Surg Obes Relat Dis 9:790-6
Jones-Corneille, LaShanda R; Wadden, Thomas A; Sarwer, David B et al. (2012) Axis I psychopathology in bariatric surgery candidates with and without binge eating disorder: results of structured clinical interviews. Obes Surg 22:389-97
Wadden, Thomas A; Faulconbridge, Lucy F; Jones-Corneille, LaShanda R et al. (2011) Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study. Obesity (Silver Spring) 19:1220-8
Sarwer, David B; Fabricatore, Anthony N; Eisenberg, Miriam H et al. (2010) Correction to: Self-reported stigmatization among candidates for bariatric surgery. Obesity (Silver Spring) 18:652
Sarwer, David B; Fabricatore, Anthony N; Eisenberg, Miriam H et al. (2008) Self-reported stigmatization among candidates for bariatric surgery. Obesity (Silver Spring) 16 Suppl 2:S75-9
Jones, LaShanda R; Fries, Elizabeth; Danish, Steven J (2007) Gender and ethnic differences in body image and opposite sex figure preferences of rural adolescents. Body Image 4:103-8
Wadden, Thomas A; Sarwer, David B; Fabricatore, Anthony N et al. (2007) Psychosocial and behavioral status of patients undergoing bariatric surgery: what to expect before and after surgery. Med Clin North Am 91:451-69, xi-xii
Sarwer, David B (2007) The psychological aspects of cosmetic breast augmentation. Plast Reconstr Surg 120:110S-117S
Sarwer, David B; Brown, Gregory K; Evans, Dwight L (2007) Cosmetic breast augmentation and suicide. Am J Psychiatry 164:1006-13

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