Eating disorders among bariatric surgery patients: The chicken or the egg?

Postoperative eating behaviors and unhealthy weight control measures are leading causes of bariatric surgery complications. Candidates for bariatric surgery and individuals with eating disorders may share common risk factors, such as a history of dieting, and/or being bullied or teased for their weight. Binge-eating disorder, night eating syndrome, and bulimia nervosa are the most common eating disorders among candidates for bariatric surgery before the operation. Malnutrition, stress, and intense fear of weight gain can lead to the development of an eating disorder after surgery as well. Plugging, grazing, loss of control eating, dumping, and food avoidance are specific disordered behaviors that may present after bariatric surgery. To improve physical and psychological outcomes for individuals under their care, clinicians can screen for these disordered behaviors and distinguish them from a healthy diet and the expected postsurgical course.