{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:45:27Z","timestamp":1790451927508,"version":"4.1.0"},"reference-count":72,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Individuals with severe obesity presenting for obesity surgery (OS) frequently show nonnormative eating behaviors (NEBs) and eating disorders (EDs), but the long-term course and prospective associations with weight loss and health-related quality of life (HRQOL) remain unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the prevalence and prospective relevance of presurgical and postsurgical NEBs and EDs according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition<\/jats:italic>, diagnosed through clinical interview, for weight loss and HRQOL up to 6 years following OS.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>In the prospective, multicenter Psychosocial Registry for Obesity Surgery cohort study, patients seeking OS were recruited at 6 OS centers in Germany and assessed at baseline before surgery and at 6 months and 1 to 6 years after surgery. From a consecutive sample of 1040 volunteers with planned OS from March 1, 2012, to December 31, 2020, a total of 748 (71.92%) were included in this study. Across follow-up, 93 of the 748 patients (12.43%) dropped out. Data were analyzed from April to November 2021.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Both NEBs and EDs were identified using the Eating Disorder Examination interview. Main outcomes were the percentage of total body weight loss (%TBWL) and HRQOL (Impact of Weight on Quality of Life-Lite; range, 0-100, with 0 indicating worst and 100 indicating best).<\/jats:p><\/jats:sec>Results<\/jats:title>In 748 patients undergoing OS (mean [SD] age, 46.26 [11.44] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 48.38 [8.09]; 513 [68.58%] female), the mean (SD) %TBWL was 26.70% (9.61%), and the mean (SD) HRQOL improvement was 35.41 (20.63) percentage points across follow-up. Both NEBs and EDs were common before surgery, with postsurgical improvements of varying degrees. Whereas NEBs and EDs did not reveal significant prospective associations with %TBWL, loss-of-control eating at follow-up was concurrently associated with lower %TBWL (estimate, \u22120.09; 95% CI, \u22120.14 to \u22120.04). Loss-of-control eating (estimate, \u22120.10; 95% CI, \u22120.17 to \u22120.03 percentage points) and binge-eating disorder of low frequency and\/or limited duration (estimate, \u22126.51; 95% CI, \u221212.69 to \u22120.34 percentage points) at follow-up showed significant prospective associations with lower HRQOL.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cohort study found prospective relevance of loss-of-control eating and binge-eating disorder of low frequency and\/or limited duration for reduced long-term HRQOL following OS. These findings underline the importance of monitoring both NEBs, especially loss-of-control eating, and EDs in the long term postsurgically to identify patients in need of targeted prevention or psychotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.26244","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T20:44:50Z","timestamp":1660596290000},"page":"e2226244","source":"Crossref","is-referenced-by-count":25,"title":["Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery"],"prefix":"10.1001","volume":"5","author":[{"given":"Anja","family":"Hilbert","sequence":"first","affiliation":[{"name":"Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, 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