Background: This study assessed eating disorder pathology in persons with obesity before and after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (DS), in a 5-year follow-up study.
Methods: Sixty participants with BMI 50-60 kg/m(2) were randomly assigned to RYGB (n = 31) or DS (n = 29). The participants completed the Eating Disorder Examination-Questionnaire (EDE-Q) before and 6 months, 1 year, 2 years, and 5 years after surgery.
Results: Before surgery, the prevalence of objective bulimic episodes was 29 % in the RYGB group and 32 % in the DS group. The prevalence improved during the first 12 months after surgery in both groups. After 5 years, the prevalence of objective bulimic episodes was 22 % in the RYGB group and 7 % in the DS group. The difference between groups throughout follow-up was non-significant (logistic regression model). A linear mixed model showed that global EDE-Q score was not a significant predictor for weight loss after surgery, but participants reporting objective bulimic episodes before surgery had significantly lower BMI than those with no episodes after 2 years (p = 0.042) and 5 years (p = 0.013). Global EDE-Q score was significantly lower in the DS group after 5 years (p = 0.009) (linear mixed model).
Conclusions: Objective bulimic episodes but not global EDE-Q score before surgery predicted greater weight loss after RYGB and DS. The DS group had a significantly lower global EDE-Q score than the RYGB group 5 years after surgery.
Keywords: BMI; Bulimic episodes; Duodenal switch; EDE-Q; Gastric bypass; Global EDE-Q score.