Secretive eating and binge eating following bariatric surgery

Some individuals eat furtively and conceal evidence of eating, and this seems to occur beyond binge-eating episodes. This type of secretive eating is common among youth and emerging evidences suggests that it is a relevant marker of eating disorder psychopathology among adults with significant eating and weight concerns.

We assessed secretive eating, loss-of-control (LOC) eating, and eating disorder psychopathology using investigator-based interviews among treatment-seeking adults experiencing LOC eating following bariatric surgery (N = 168). Participants also completed an established depression measure; height and weight were measured.

Overall, 37% of patients reported secretive eating: 54% of patients who met criteria for binge-eating disorder except for the size criterion ("bariatric BED") and 25% of patients with subthreshold bariatric BED reported secretive eating. Many clinical variables were higher among patients with secretive eating compared to those without secretive eating; however, only eating disorder psychopathology severity and body dissatisfaction remained significantly higher among patients with secretive eating compared to those without when bariatric BED status was also included as a variable in the model.

Findings suggest that among post-bariatric surgery patients with LOC eating, secretive eating signals more severe eating disorder psychopathology overall and specifically related to dissatisfaction with weight and shape. Bariatric BED status, however, has a stronger association than secretive eating with many clinical variables. Secretive eating should be assessed and considered when addressing weight and shape concerns among patients experiencing LOC eating after bariatric surgery.