(i) terms synonymous with disordered eating: eating disorder$ or disordered eat$ or eating behav$ or eating psychopatholog$ or binge$ or grazing or graze$ or bulimia or binge-eating disorder or eating habit$ or eating pattern$ or eating attitude$ or loss of control or over eat$;
(ii) terms synonymous with overweight/obesity: weight or BMI or body mass or waist hip ratio or adipos$ or waist circumference or obes$ or over weight$ or body size or body fat;
(iii) terms synonymous with surgery: surgery or surgical or obesity treatment or bariatric surg$ or gastric bypass or gastroplasty or LAGB or Lap-Band$ or gastric band$ or postoperative outcome$.
Figure S1. Search Strategy Key Words and Mapped Subject Headings.
1. eating disorder$ or disordered eat$ or eating behav$ or eating psychopatholog$ or binge$ or grazing or graze$ or bulimia or binge-eating disorder or eating habit$ or eating pattern$ or eating attitude$ or loss of control or over?eat$ or over eat$
2. exp eating disorders/
3. #1 OR #2
4. weight or BMI or body mass or waist hip ratio or adipos$ or waist circumference or WC or obes$ or over?weight$ or over weight$ or body size or body fat
5. "body weights and measures"/ or exp body fat distribution/ or exp body mass index/ or exp body size/ or exp waist-hip ratio/
6. #4 OR #5
7. surgery or surgical or obesity treatment or bariatric surg$ or gastric bypass or gastroplasty or LAGB or Lap-Band$ or gastric band$ or postoperative outcome$
8. exp general surgery/ OR exp Bariatric Surgery/
9. #7 OR #8
10. #3 AND #6 AND #9
11. Limit #10 to english language
12. Limit #11 to animals
13. #11 NOT #12
14. Limit #13 to All child 0-18yrs
15. #13 NOT #14
Figure S2. Example Search Strategy – Medline Database.
43
Table S1. Studies Assessing Disordered Eating in the Post-operative Bariatric Surgery Population.
Study / Sample N / Sex (%F) / Age yrs (sd/range) / BMI (sd/range) / Surgery / Length of follow-up / Country & Ethnicity % (n) /[1] / 39 / 90%F / 50.3±7.6 / 90.23±17.88 kg / LRYGB / 4 yr / US
Caucasian 75%
African American (8)
Hispanic (1)
[2] / 35 / 80%F:20%M / NR / NR / RYGB / 1 yr / US
White 53%
[3] / 1001 / 804F:187M
(80%F) / NR / NR / RYGB / Up to 30 mths / US
[4] / 131
Non-BED: 80 initially, 51 had 12mth weight measure.
BED: 51 initially, 30 had 12mth weight measure. / NR / NR / NR / RYGB or AGB / 12 mths / US
[5] / 138 / 138F (100%F) / 42 (22-62) / NR / NR / NR / Netherlands
[6] / 78 total; 60 (76%) completed questionnaires
Grp 1 n: 35, post-op (mths): 6.7±3.0
Grp 2 n: 25, post-op (mths): 18.8±5.8 / Grp 1=28F:7M
(80%F)
Grp 2=21F:4M
(84%F) / Grp1=39.7±11.5
Grp2=43.9±12.6 / Grp1=31.6±5.1
Grp2=31.3±4.5 / Laparoscopic sleeve gastrectomy / Grp 1 <1yr;
Grp 2 >1 yr / Israel
[7] / 16 / 12F:4M (75%F) / 24-44 (36.8) / NR / NR / NR / Sweden
[8] / 70 / F (100%F) / 38.6 (10.3) / 47.4 (7.6) / RYGB / 1 yr / France
[9] / 43 / F (100%F) / NR / NR / NR / 1 & 2 yrs / Switzerland
[10] / 136 / 101F:35M
(74.3%F) / 41.4±10.6 (20-64) / 29.5±4.7 (19.7-42.1) / GBP / >1yr (22.5±17.2 mths) / Switzerland
[11] / 30 / NR / NR / NR / VBG / 3, 12, 36 mths / Greece
[12] / 22 / NR / NR / NR / LAGB / NR / UK
[13] / 132 / 84F:49M
(63.6%F) / 43±11 / 34.4±7.1 (22.1-42.6) / BPD / ≥1yr (40±4.3mths) / Italy
[14] / 27 (variable) / 26F:1M
(96.3%F) / NR / Weight (kg) self-report=86.33±17.26
Weight (kg) physician-report=90.23±17.88 / LRYGB / 4yrs / US
[15] / 197 (148 participated, 75%) / 84%F / 45.9 / Pre-op=46.2
Post-op NR / LRYGB / 40.1±15.3 mths (15.4-72.1mths) / US
Hispanic 20%
White 72.3%
Black 12.8%
Asian 0.7%
American Indian or Alaskan Native 3.4%
[16] / 6mth=311 (86.1%)
12mth=294 (81.4%)
24mth=171 (47.4%) / NR / NR / NR / GBP / 6, 12, 24 mths / US
[17] / 1yr=135 (96%)
Last visit at 8±1.2yrs=80 (59%) / NR / NR / 1 yr=31.6±6.2
Last visit=34.5±6.2 / RYGB / 8±1.2 yrs / Switzerland
[18] / 497 / 475F:22M
(95.6%F) / 43.2 (8.4) (21-65) / NR / RYGB / 3-10yrs (4.2) / US
White 90.1% (445)
Black/African American 5.5% (27)
Hispanic/Latino 2.8% (14)
Native American 0.8% (4)
[19] / 59 / NR / 50F:9M / 32.6 / RYGB / 1.9yrs (0.4) (18-35mths) / US
[20] / 60 / 44F:16M
(73.3%F) / NR / Pre=42.3 (38.1-63.5)
Post=31.7 (22.3-38.1) / BPD / 24-72 mths / Italy
[21] / 112 / NR / NR / 31.9±5.9 / VGB / 2 yrs / Netherlands
[22] / 151 / F&M / NR / Post BMI
no T1 diagnosis= 38.3 ± 7.0
T1 Anx/dep= 43.9 6.4 / LAGB / 4yrs / Germany
[23] / 34
BED: 16
No BED: 18 / F (100%F) / BED=38.4 (7.6)
No BED=42.7 (6.5) / BED=40.2 (8.2)
No BED=35.8 (6.0) / NR / BED: 42.6mths (15.1);
No BED: 46.0mths (13.1) / Netherlands
[24] / 1yr=131
3yr 2mth=122
(attended both follow-ups=79) / 84%F / 1yr=44.03 (11.30)
3yr=47.05 (10.35) / 1 yr=30.55 (6.09)
3 yr=30.18 (6.98) / GBP / Mean 1yr, 3yr / US
[25] / 11 / 81%F:19%M / 52.00±7.59 / 41.42±5.41 / LAGB, RYGB / 5.63±2.91mths / US
White 91%
Black 9%
[26] / 105 (initial) / 86 F:14M
(81.9%F) / 45.8 (10.3) / Max BMI=48.6 (9.1)
Entry BMI=28.4 (5.6) / RYBG, LAGB / NR; Assessment made at 1yr after registry in study / US
Surgical:
Caucasian 92.4%
African American 6.7%
Hispanic 0.0%
Others 1.0 %
[27] / Wk 20=198
Wk 40=147
Wk 66=92
Wk 92=112 / NR / NR / NR / RYGB / 20, 40, 66, 92 wks / US
[28] / 7 / 6F:1M
(85.7%F) / 54 (49-64) / 35.0-52.4 / GBP & LAGB / 2-11 mths / US
African American (1)
Caucasians (6)
[29] / 15 / 12F:3M
(80%F) / NR / 30.8±3.4 / Laparoscopic sleeve gastrectomy / 6mths / Austria
[30] / 129 / 103F:26M
(79.8%F) / NR / 35.0±6.0 / LAGB / 12 mths / Australia
[31] / 129
Same sample as [30] / 103F:26M
(79.8%F) / NR / 35.0±6.0 / LAGB / 12 mths / Australia
[32] / 139 / 123F:16M
(88.5%F) / NR / NR / GBP / 6 & 12 mths / US
[33] / 6mth=88
1 yr=89 / 80F:11M
(6mth 90.9%F;
1 yr 89.9%F) / NR / 6mth=34.2±5.0
1yr=32.6±5.0
2yr=32.1±6.0 / VBG / 6, 12, 24 mths / Netherlands
[34] / 29 / 28F:1M
(96.6%F) / NR / NR / AGB / 5 yrs / UK
[35] / 21 / F (100%F) / NR / NR / LAGB / 4, 5, 6 yrs / Austria
[36] / 236 / 210F:26M
(89%F) / 42.9 / 35.3 (7.02) / VGB (201) or GBP (35) / 8.2 (4.49) yrs / Netherlands
[37] / 38 / 32F:6M
(84.2%F) / NR / 32.98±5.29 / VBG / 1, 3, 6mths / Italy
[38] / 176 / 140F:36M
(79.5%F) / Patients divided into younger (18-40) & older (41-65) groups / NR / LAGB / 50mths (30-84) / Austria
[39] / 13 / F (100%F) / NR / 32.0 (5.8) / RYGB / 12mth / US
[40] / 35 / 31F:4M
(88.6%F) / NR / 37.8±5.5 / LAGB / 1 yr / Italy
[41] / 77 (60% RR) / 68F:9M
(88.3%F) / NR / 38 (7) (25-55) / LAGB / 12 mths / Netherlands
[42] / 93 (47.9%) / 81F:12M
(87.1%F) / 44.3±9.7 / NR / RYGB / 78.4±35.7 wks (17.3-199.4) / US
Caucasian 75%
Hispanic 18.5%
[43] / 139 / 124F:15M
(89.2%F) / NR / NR / GBP / 12 mths / US
White 70.5%
African American 16.5%
Hispanic American 11.5%
Other 1.4%
[44] / 157 (81.6% response) / 144F:13M
(91.7%F) / 40.0 (7.9) / 35.3 (6.9) / LAGB / 33.9 (15.1) / Netherlands
[45] / 140 (63% response) / 140F
(100%F) / NR / NR / AGB / >30mths, 50 (30-84) / Austria
[46] / 109 / 97F:12M
(89.0%F) / NR / 6mth=37.06 (6.22) 12mth=33.04 (5.61) / GBP / 6 & 12 mths / US
White 67% (73)
Black 18% (20)
Hispanic 14% (15)
Asian 1% (1)
[47] / 137 / 122F:15M
(89.1%F) / NR / NR / GBP / 12 mths / US
Caucasian 70.8% (97)
African American 16.8% (23)
Hispanic-American 10.9% (15)
Other 1.4% (2)
[48] / 65 / NR / 43.5 (9.8) (21-65) / 34.9 (5.5) / LAGB, RYGB (47:9) / 3.2 yrs (1.3) (0.2-5.8) / Switzerland
[49] / 22 / 21F:1M / 40.86±8.39 / 37.92 (9.75) / LAGB (16), RYGB (6) / 15 mths (4-48) / UK
White 18
Black 3
Other 1
[50] / 21 / 21F
(100%F) / NR / 33.8 / LAGB / Every 6 mths to 3 yrs / Germany
[51] / 149 / 102F:47M
(68%F) / NR / 38.6±6.8 / VBG or AGB / 14±1.5 / Germany
[52] / 23 / 20F:3M
(87.0%F) / NR / 39.2±1.0 / LAGB / 6 mths / Austria
[53] / 64 / NR / NR / NR / NR / ≥6 mths / US
[54] / 56 / NR / NR / NR / GBP / 12 / US
[55] / 65 / 65F
(100%F) / NR / 34.1 (8.5) / GBP / 16.4 / US
White 40%
African American 30%
Hispanic 30%
[56] / 93 / ≤2 yrs: 42F:6M; Post>2 yrs: 102F:7M
(91.7%F) / ≤2 yrs: 40 (24-61); Post>2 yrs: 41 (22-55) / ≤2 yrs: 45.5 (37-72); >2 yrs: 45.4 (36-63) / LAGB / 68 mths / Netherlands
[57] / 65 (BE: 33; NBE: 32) / 48F:17M
(74%F) / NR / 40.8 (9.0) / RYGB / 5-7 mths / US
White 77% (50)
Black 20% (13)
Hispanic 3% (2)
[58] / 45 / 39F:6M
(86.7%F) / 42 (20.2-65.1) / 34.6 (7.2) (21.9-65.2) / RYGB / 1.5 yrs (6 mths-3 yrs) / US
[59] / 40 / 34F:6M
(85%F) / NR / 38.9 (7.5) / RYGB / 6 mths / US
Caucasian 79% (31)
[60] / 140 / BE: 15F:10M; NBE: 95F:20M
(78.6%F) / BE: 36.46 (11.72); NBE: 44.61 (9.92) / NR / VGB / 18 mths / Spain
[61] / 66 (97; 68%) / 87.9%F:12.1%M / NR / 39.7 (9.2) / LAGB / 3, 6, 9, 12 mths / Switzerland
[62] / 99 (156; 63.5%) / BE: 31F:13M; NBE: 46F:6M
(77.8%F) / At operation: BE: 40.4 (10.2); NBE: 42.8 (11.2) / BE: 34.4 (7.8); NBE: 33.1 (6.7) / RYGB / BE: 4.0 (1.5); NBE: 4.0 (1.4) (>2 - <7 yrs) / US
[63] / 99 / 31F
(100%F) / 38 (8.87) (20-58) / NR / AGB / ≥2 yrs / Netherlands
[64] / 100 / 85F:15M
(85%F) / 40.5±11.15 / 33.49±6.31 / VBG / 18 mths / Spain
[65] / 78 / 65F:13M (83.3%) / 54.1 (31-77) / 32.8 (22.7-49.5) / RYGB / 13.8 yrs (12.5-15.6) / US
Caucasian 100%
[66] / 152 / 128F:24M
(84.2%F) / 35.5 (11.3) (15-61) / NR / LAGB / <3 yrs / Italy
[67] / NR / NR / NR / NR / GBP / NR / US
[68] / Same sample as [64] / 85F:15M
(85%F) / 40.50 (11.15) / NR / VBG / 18.0±4.95 mths / Spain
[69] / 26 / NR / NR / 39.3 (7.3) (29-53) / RYGB / 1-3 wks, 6 mth / US
Caucasian 59%
African American 28%
Hispanic 6%
Other 6%
[70] / 56 / 45F:11M
(80.4%F) / 42.3 (20-57) / Post Grp 2: 49.07 (0.67) / BPD / 79 mths (2-15 yrs) / US
[71] / 67 / 86%F:14%M / 43.5±9.7 / 29.2±5.7 / GBP: 58% (39); VBG 18% (12); Unspecified: 24% (16) / 1.9 yrs / US
Caucasian 89.6%
[72] / 6 mths: 101; 1yr: 90; 2yr: 74 / NR / NR / 39.6 (11.1) / NR / 6 mths, 1 & 2 yrs & average 5.5 yrs (0.5-10.5 yrs) / US
Caucasian 73%
[73] / 50 / NR / NR / 41.89 (9.33) / RYGB / 3.84 (0.89) mths / US
[74] / 107 / 90F:17M
(84.1%F) / 42.5 (10.75) / NR / GBP or LAGB / 9 / Australia
[75] / 89 / 81F:8M
(91.0%F) / NR / NR / Gastroplasty / 12 mths / Canada
[76] / 63 / 48F:15M
(76.2%F) / NR / NR / BPD / 3 yrs / Italy
[77] / 487 / 327F:160M
(67.1%F) / NR / M: 31.5; F: 32.5 / LAGB, VBG & GBP / 2 yrs / Sweden
[78] / 51 / 39F:12M
(76.5%F) / NR / BED: 29.7±4.5; Non-BED: 29.0±5.2 / BPD / 1, 2, 3 yrs / Italy
[79] / 111 / 91.3%F:8.7%M / 44.6±10.4 / 28.7±6.4 / NR / 32 (30) mths / US
White 94.7%
[80] / 27 / NR / 40.4±10.1 / 29.86±5.4 / GBP / 20.8±11.0 mths / US
[81] / 34 / NR / NR / GBP kg:71.42 (13.97); Waiting list kg: 111.35 (15.79) / GBP / 2 yrs 8 mths (11 mths) / Australia
[82] / 65 / 49F:16M
(75.4%F) / NR / 28.4 (20.3-40.3) / BPD / 1, 2 yrs / Italy
[83] / 20 / 16F:4M
(80%F) / NR / Successes: 29.6 (SEM 1.1); Failures: 37.0 (SEM 1.6) / VBG / 1, 3, 6, 12 mths / Sweden
[84] / Same sample as [76] / 48F:15M
(76.2%F) / NR / 28.6 (0.55) (20.3-40.1) / BPD / 1, 2 yrs / Italy
[85] / Same sample as [76, 84] / 48F:15M
(76.2%F) / NR / 28.6 (0.55) (20.3-40.1) / BPD / 1, 2 yrs / Italy
[86] / 20 / 16F:4M
(80%F) / F: 42 yr 6 mth (9yr 4 mth); M: 47 yr (8 yr 7 mth) / 118.13 (17.47) kg / GBP / 24.42 (9.13) mths / Australia
[87] / 68 / 49:F19M
(72.1%F) / NR / 30.7 (18-53.4) / BPD / 12 mths / Italy
[88] / 98 / 71F:27M
(72.4%F) / 40 (18-64) / 26 (20-29) / BPD / NR / Italy
[89] / 110 / ST BPD (39): 28F:11M; LT BPD (71): 56F:15M
(76.4%F) / Post group: 35 (28-58) / 28 (17-36) / BPD / 12-177 mths; ST BPD: 14 (12-23); LT BPD: 53 (26-177) / Italy
[90] / 16 / 12F:4M
(75%F) / NR / NR / Scopinaro operation / 3 mths, 1 & 2 yrs / UK
[91] / 39 / 36F:3M
(92.3%F) / 37 (median 38) / 80.1 kg (15.6) / NR / 17 mths (2-24) / New Zealand
[92] / 29 / 23F:6M
(79.3%F) / NR / 226.36 lbs (38.01) / VBG / 10.54 / US
[93] / 31 / 90.3%F / 38.3 (24-55) / NR / Gastric stapling / 1.7 yrs (1-4) / Canada
[94] / 100 (1 yr: 100; 3 yr: 60) / 1 yr: 76F:24M; 3yr: 51F:9M
(>75%F) / 1 yr: 38±10; 3 yr: 39±9 / 1 yr F: 118±15 kg; M: 152±23 kg. 3 yr F:120±19; M: 146±17 / RYGB / 1 (14±2), 3 (35±3) yrs / US
[95] / Same sample, methodology & measurement of ED as [94] / 1 yr: 76F:24M; 3yr: 51F:9M
(>75%F) / 1 yr: 38±10; 3 yr: 39±9 / 1 yr F: 118±15 kg; M: 152±23 kg. 3 yr F:120±19; M: 146±17 / RYGB / 1 (14±2), 3 (35±3) yrs / US
[96] / 33 / NR / NR / NR / GBP / 24 mths / US
White 76%
Black 24%
[97] / 3 mths: 17; 6 mths: 13; ≥12 mths: 7 / NR / NR / NR / Gastroplasty or GBP / 3, 6, 12 mths / Canada
[98] / 44 / 37F:6M (1 NR)
(84.09%F) / 35.2 (22-50) / NR / NR / 11 mths (3-35) / US
Anglo-American (34)
Hispanic (6)
Black (1)
American Indian (1)
Unspecified (2)
[99] / Grp 1 (Q): 27; Grp 2 (Int): 20 / Grp 1: 20F:7M
(74.1%) / Grp 1: 37 / Grp 1: 131±46 kg (66-248) / Jejunoileal bypass / >8 ≤18 mths / Grp 1: White (22) Black (2) Native American (3)
[100] / 69 / 56F:13M
(81.2%F) / 41±9.9 (21-54) / 91 kg (17) / Jejunoileal bypass / 37±19 mths (>1 yr) / US
AGB: Adjustable Gastric Banding; BED: Binge Eating Disorder; BPD: Biliopancreatic diversion; GBP: Gastric Bypass; LAGB: Laparoscopic Adjustable Gastric Banding; NR: Not reported; RYGB/LRYGB: (Laparoscopic) Roux-en-Y Gastric Bypass; VBG: Vertical Banded Gastroplasty.
43
Table S2. Methods of Assessing Disordered Eating Following Bariatric Surgery.