Binge Eating and Addictive-Like Eating Behaviors Seven Years After Sleeve Gastrectomy: Implications for Long-Term...

Binge eating (BE) and addictive-like eating behaviors, as assessed by the Yale Food Addiction Scale (YFAS) may change following metabolic bariatric surgery (MBS), yet their long-term trajectories and relationship with weight recurrence remain unclear. We examined their prevalence, longitudinal course, and associations with weight outcomes seven years following sleeve gastrectomy (SG).

Women who underwent primary SG (n = 62) were evaluated prospectively at baseline and at 3, 6, 12, and 24 months, and 7 years post-surgery. Addictive-like eating behaviors and BE were assessed using the YFAS and Binge Eating Scale (BES), respectively. Longitudinal changes and associations with 7-year weight recurrence from nadir were examined.

Thirty women completed the 7-year follow-up. At baseline, addictive-like eating behaviors and BE were identified in 40.0% and 46.0% of participants, respectively. Prevalence declined at 6 months (addictive-like eating behaviors: 8.7%, BE: 10.6%), followed by a gradual increase by 7 years (addictive-like eating behaviors: 21.4%, BE: 26.9%). Baseline behaviors were not associated with weight recurrence at 7 years. In contrast, BE at 7 years was associated with greater weight recurrence from nadir (P = 0.015), whereas addictive-like eating behaviors were not.

Although BE and addictive-like eating behaviors decline substantially during the early postoperative period following SG, both may gradually re-emerge over long-term follow-up. BE present at 7 years, but not addictive-like eating behaviors, was associated with significantly greater weight recurrence from nadir, underscoring the importance of sustained behavioral and psychological monitoring during long-term postoperative care.