Recent research led by Thomas H. Inge, M.D., Ph.D., director of the Bariatric Surgery Center at Children's Hospital Colorado (Children's Colorado), examined the impact of eating behaviors on success rates related to bariatric surgery in adolescents. The five-year study involved 242 adolescents, ages 13-19 years, who underwent bariatric surgery at five different centers across the United States from 2007 to 2012.

The study specifically examined loss of control eating, which is characterized by a sense that an individual cannot control what or how much they are eating. Reported by up to 30 percent of adolescents with obesity, loss of control eating typically takes one of two forms -- either eating objectively large amounts of food or eating continuously.

"With approximately 10 percent of adolescents in the U.S. suffering from severe obesity, bariatric surgery is increasingly being recommended as an effective long-term treatment," said Dr. Inge. "However, several behaviors, including loss of control eating, that are common in adolescents with obesity may undermine bariatric surgery outcomes. This research demonstrates that patients should not only undergo nutritional and mental health assessments before bariatric surgery, but also continuing to focus on these important factors after surgery is important to achieving the best possible long-term outcomes."

The study, published in Pediatrics, found that while loss of control eating sharply declined among the study participants immediately following bariatric surgery, loss of control eating gradually increased throughout the four-year follow-up. Importantly, the presence of loss of control eating before surgery did not appear to impact long-term weight loss. However, engaging in loss of control eating at one, two and three years post-surgery was associated with significantly poorer weight loss outcomes.

"Loss of control eating is related to a variety of psychological health concerns, including depression and anxiety," said Richard E. Boles, Ph.D., pediatric psychologist in the Bariatric Surgery Center at Children's Colorado. "Physicians, therefore, not only need to be aware that loss of control eating is a common behavior in adolescents seeking bariatric surgery, but they also should understand what drives this behavior in their patients. They should ask their patients if they ever experience a feeling of being unable to control what or how much they are eating and closely monitor these symptoms at follow-up visits to determine the need to refer them for more intensive psychological treatment."