Examining the psychological correlates of binge eating disorder symptomatology in a morbidly obese presurgical sample

Bariatric surgery is considered the most effective weight loss intervention for morbidly obese individuals. A successful outcome is largely dependent on a patient\u27s ability to make and maintain the necessary postoperative lifestyle adjustments. Early studies have suggested that the presence of certain psychiatric disorders have the potential to interfere with patients\u27 ability to make these adjustments. To date, little is known about the actual prevalence of psychiatric disorders and their associated features in bariatric presurgical patients. The current study has four main aims. Aim 1 examined the lifetime and current prevalence of Axis I and II psychiatric disorders with an emphasis on their comorbidity with binge eating disorder in a sample of 500 presurgical bariatric candidates. Aim 2 evaluated the diagnostic validity of the Psychiatric Diagnostic Screening Questionnaire (PDSQ). Aim 3 investigated the psychological correlates of subthreshold binge eating disorder. Aim 4 examined the relations between psychosocial factors, binge eating disorder, and depressive disorder. Five major findings are noteworthy. First, an estimated 25% of our sample was diagnosed with a current Axis I psychiatric disorder and less than 5% was diagnosed with an Axis II psychiatric disorder. Second, patients with binge eating disorder were significantly more likely to have a comorbid Axis I psychiatric disorder compared to those without a diagnosis. Third, patients with subthreshold binge eating disorder more closely resembled those with binge eating disorder as opposed to those without the disorder on weight-related impairment. Fourth, results provided partial support for the diagnostic validity of the PDSQ. Fifth, low self-esteem was predictive of binge eating disorder and depressive disorder and the relationship between self-esteem and depressive disorder was partially mediated by binge eating disorder. These findings have important implications for understanding the psychological characteristics of presurgical bariatric patients and the development of preoperative therapeutic interventions. Longitudinal studies are critically needed to examine the impact of psychological variables on postoperative outcomes