Psychopathology, disordered eating, and impulsivity in patients seeking bariatric surgery

Most patients who undergo bariatric surgery experience significant weight loss and improvements in obesity-related co-morbidities in the first 6–18 months after surgery. However, 20%–30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. Psychosocial functioning may contribute to suboptimal weight loss and/or postoperative psychosocial distress. Assess psychosocial functioning, eating behavior, and impulsivity in patients seeking bariatric surgery. Two university hospitals. Validated interviews and questionnaires. Impulsivity assessed via computer program. The present study included a larger (n = 300) and more racially diverse (70% non-White) sample than previous studies of these relationships. Forty-eight percent of participants had a current psychiatric diagnosis and 78% had at least 1 lifetime diagnosis. Anxiety disorders were the most common current diagnosis (25%); major depressive disorder was the most common lifetime diagnosis (44%). Approximately 6% of participants had a current alcohol or substance use disorder; 7% had a positive drug screen before surgery. A current psychiatric diagnosis was associated with greater symptoms of food addiction and night eating. Current diagnosis of alcohol use disorder or a lifetime diagnosis of anxiety disorders was associated with higher delay discounting. The study identified high rates of psychopathology and related symptoms among a large, diverse sample of bariatric surgery candidates. Psychopathology was associated with symptoms of disordered eating and higher rates of delay discounting, suggesting impulse control issues. •The rate of the major current and lifetime psychiatric diagnoses are consistent with previous studies in patients seeking bariatric surgery•A current psychiatric diagnosis was associated with symptoms of other relevant conditions, including depression, food addiction and night eating.•The presence of some psychiatric diagnoses were associated with greater delay discounting of a future reward.•The rate of current substance use disorder in candidates was low; however, 19 patients (7%) had a positive urine drug screen, suggesting that some patients engaged in ‘impression management’ in minimizing their use of illicit substances.