An Explorative Analysis of Binge Eating Disorder Impulsivity among Obese Candidates to Bariatric Surgery

Introduction: DSM-5 included Binge Eating Disorder (BED) in Eating Disorders indicating binge as psychopathological marker. Impulsivity formed by neuroanatomical and psychosocial factors contributes to binge. Obesity mental dimensions: impulsivity, body image, mood and anxiety participate to eating behaviours. They can be distinguished in gorging, snacking, grazing and binge. Impulsivity is generally investigated in obese subjects without making differences among them. This study's aim is to highlight the differences between obese BED and non-BED candidates to bariatric surgery assessing: quantity and quality of impulsivity among eating behaviors; different facets of impulsivity; weight regain after bariatric surgery as consequence of impulsivity disorder. Methods: 1355 obese subjects underwent psychiatric assessment before bariatric surgery. 984 were selected and enrolled in this study, divided into two groups based on eating behavior: binge eating and gorging/snacking considered as sample of low psychopathology. Every patient underwent psychiatric evaluation. It consists of: psychiatric examination, eating behavior structured interview, impulsivity psych diagnosis: BIS-11, BES and EDI-2. Barratt inner factors: cognitive, motor and non-planning factors were also considered associated with EDI-2 subscales indicating impulsivity. Statistical analysis was performed using Pearson Chi square test, Ancova and TTest. Significance was set at p<0.001. Results: Data analysis shows a global increase of impulsivity in obese BED versus non BED. Inner impulsivity facets indicate that binge is characterised by increase of CF and MF higher than NPF related to increase of EDI-2 subscales: I, IR, IA, Bu. Conclusion: This study shows that BED obese subjects suffer from a global impulsivity disorder. The alterations of its inner factors associated to EDI-2 subscales: interoceptive awareness, insecurity and insufficient impulse regulation stress emotional regulation disorder and the inability to control food-intake. This lack of control determines poor compliance after bariatric surgery and weight regain.