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BackgroundFood addiction and binge eating are common among individuals with obesity. However, a paucity of studies prospectively examined the prevalence and implications of food addiction before and post-bariatric surgery. We aimed to examine the prevalence of food addiction and binge eating before and after sleeve gastrectomy (SG) and to assess their associations with behavioral and weight loss outcomes.MethodsWe followed at 3 (M3), 6 (M6), and 12 (M12) months postoperative, 54 women who underwent SG. Data collected including anthropometrics, nutritional intake, food tolerance, and physical activity measures. The Yale Food Addiction Scale and the Binge Eating Scale were used to characterize food addiction and binge eating, respectively.ResultsThe mean baseline age and BMI were 32.1 ± 11.1 years and 44.9 ± 4.9 kg/m2, respectively. Pre-surgery, food addiction, and binge eating were identified in 40.7% and 48.1% of patients, respectively. The prevalence of food addiction decreased significantly up to M6, but increased to 29.3% at M12. The prevalence of binge eating decreased significantly through the follow-up up to 17.4% at M12. Those who met criteria for food addiction at M12 achieved significantly lower excess weight loss at M12 compared with those not meeting this criterion (P = 0.005). Food addiction scores at M12 negatively correlated with weekly physical activity (r = − 0.559; P < 0.001) and food tolerance scores (r = − 0.428; P = 0.005).ConclusionsThe reduction in food addiction observed at M6 was not maintained at M12. Food addiction at M12 was associated with poorer weight loss, eating, and lifestyle behaviors. Clinical practice should focus on the psychological aspects associated with obesity.

ObjectiveFood addiction and binge eating share overlapping and non-overlapping features; the presence of both may represent a more severe obesity subgroup among treatment-seeking samples. Loss-of-control (LOC) eating, a key marker of binge eating, is one of the few consistent predictors of suboptimal weight outcomes post-bariatric surgery. This study examined whether co-occurring LOC eating and food addiction represent a more severe variant post-bariatric surgery.MethodsOne hundred thirty-one adults sought treatment for weight/eating concerns approximately 6 months post-sleeve gastrectomy surgery. The Eating Disorder Examination-Bariatric Surgery Version assessed LOC eating, picking/nibbling, and eating disorder psychopathology. Participants completed the Yale Food Addiction Scale (YFAS), the Beck Depression Inventory-Second Edition (BDI-II), and the Short-Form Health Survey-36 (SF-36).Results17.6% met food addiction criteria on the YFAS. Compared to those without food addiction, the LOC group with food addiction reported significantly greater eating disorder and depression scores, more frequent nibbling/picking and LOC eating, and lower SF-36 functioning.ConclusionNearly 18% of post-operative patients with LOC eating met food addiction criteria on the YFAS. Co-occurrence of LOC and food addiction following sleeve gastrectomy signals a more severe subgroup with elevated eating disorder psychopathology, problematic eating behaviors, greater depressive symptoms, and diminished functioning. Future research should examine whether this combination impacts long-term bariatric surgery outcomes.

Background: The hypothesis of “cross-addiction” has never been validated, and numerous aspects speak against it. Objectives: To compare the differences between sleeve gastrectomy (SG) and gastric bypass (GB) procedures concerning cross-addiction. Setting: Center for maximum care in Germany. Methods: We performed a prospective analysis of patients undergoing SG or GB as the first surgical treatment for severe obesity. All patients completed validated questionnaires to evaluate food intake (Yale Food Addiction Scale, YFAS), alcohol intake (Alcohol Use Disorders Identification Test), nicotine use (Fagerstrom Test for Nicotine Dependence), exercise (Exercise Addiction Inventory), drug addiction (20-item Drug Abuse Screening Test), and Internet use disorder (Internet Addiction Test) before the operation (T0) and 6 (T6) and 24 (T24) months postoperatively (ClinicalTrials.gov identifier: NCT02757716). Results: One hundred thirteen patients underwent SG (n = 68) or GB (n = 45). At the follow-up, 61% completed the questionnaires at T6 and 44% at T24. In the YFAS, the percentage of patients diagnosed with food addiction decreased from 69 to 10%, and the mean symptom count decreased from 3.52 ± 1.95 to 1.26 ± 0.99 at T24 (p < 0.0001); these values did not differ between the surgical groups (p = 0.784). No significant evidence of cross-addiction was observed for use of alcohol, nicotine, drugs, the Internet, or exercise in either surgical group. The percentage of patients with moderate nicotine dependence increased in the SG group (+8.9%) at T24, but this was not significant. Conclusion: In this single-center cohort study, surgery for obesity caused significant addiction remission regarding food but without inducing cross-addiction after 2 years. Importantly, no significant differences were seen between the SG and GB procedures.

The current treatment for obesity-related type 2 diabetes is not able to achieve sufficient metabolic control. New remission prospects have been offered through bariatric surgery and other interventional therapies. The aim of the study is to illustrate the mechanism by which such therapies affect the autonomic system, in particular the afferent vagal activity. The first and most important terminal of this activity is the brainstem vagal nucleus tractus solitarius . Its function, on which the vagal efferent inputs that control the splanchnic organs depend, is conditioned by the level of synaptic transmission within it. In conclusion, on the basis of such a view, a selective pharmacological modulation of such transmission as the target for future medical treatment of obesity and related type 2 diabetes is proposed.

Purpose of Review With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addicted patients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. Recent Findings Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths. Furthermore, opioid-addicted patients have notoriously undertreated pain in the perioperative period. A multitude of strategies are available in the perioperative period to treat pain in these patients. Summary Formulating treatment plans for opioid and non-opioid-addicted patients undergoing surgery should include considerations in the pre-, intra-, and post-operative period. Our review article outlines several non-opioid modalities which may be employed to treat pain in these patients; however, particularly in the opioid-addicted population, the practitioner must be aware that non-opioids alone may not suffice to treat post-surgical pain. Consultation with pain management may be warranted to optimize opioid and non-opioid treatment for these patients.

\"Surgery Junkies is an innovative, fast-paced mix of theory and empirical research that advances our understanding of contemporary bodies, lifestyle medicine, and the making of the embodied, self-fashioned self. Scholars and teachers of cultural and media studies, sociology of the body, and health and society will value its contributions to both their research and their teaching.\"-Arthur W. Frank, author of The Wounded Storyteller: Body, Illness, and Ethics and The Renewal of Generosity: Illness, Medicine, and How to Live \"Whether analyzing Extreme Makeover, 'Body Dismorphic Disorder,' or her own rhinoplasty, Pitts-Taylor makes difficult theoretical concepts clear-and clearly relevant to our lives.\"-Susan Bordo, author of Unbearable Weight: Feminism, Western Culture, and the Body Despite the increasing prevalence of cosmetic surgery, there are still those who identify individuals who opt for bodily modifications as dupes of beauty culture, as being in conflict with feminist ideals, or as having some form of psychological weakness. In this ground-breaking book, Victoria Pitts-Taylor examines why we consider some cosmetic surgeries to be acceptable or even beneficial and others to be unacceptable and possibly harmful. Drawing on years of research, in-depth interviews with surgeons and psychiatrists, analysis of newspaper articles, legal documents, and television shows, and her own personal experience with cosmetic surgery, Pitts-Taylor brings new perspectives to the promotion of \"extreme\" makeovers on television, the medicalization of \"surgery addiction,\" the moral and political interrogation that many patients face, and feminist debates on the topic. Pitts-Taylor makes a compelling argument that the experience, meanings, and motivations for cosmetic surgery are highly social and, in doing so, provides a much needed \"makeover\" of our cultural understanding of cosmetic surgery. Victoria Pitts-Taylor is associate professor of sociology at Queens College and the Graduate Center, City University of New York. She is the author of In the Flesh: The Cultural Politics of Body Modification.

The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample.

There are different treatments for food addiction (FA) symptomatology, but a comprehensive review with a meta-analysis to determine the most effective intervention is lacking. The aim of this review is to investigate the efficacy of pharmacological, behavioral, and bariatric-metabolic surgical interventions in reducing FA symptomatology. Meta-analyses including 15 studies in adults showed a significantly positive effect (std mean difference in FA symptoms before vs after intervention 0.72 (0.58–0.95)), with bariatric-metabolic surgical interventions showing the highest efficacy in improving FA symptoms (1.17 (0.58–1.76) before vs after intervention). The existing evidence suggests a beneficial effect of bariatric-metabolic surgical, pharmacological, and behavioral interventions, in that order, on FA symptomatology in people with overweight/obesity. Weight loss and behavioral and lifestyle changes after surgery may be determinants in improving FA symptomatology.

Purpose Weight regain after metabolic bariatric surgery is a common problem. Food addiction is an eating disorder that can be one of the reasons for weight regain in these patients. This study aimed to evaluate the effects of probiotic supplementation with a weight loss program and cognitive behavioral therapy (CBT) on anthropometric measures, eating behavior, food addiction, and related hormone levels, in patients with food addiction and weight regain after metabolic bariatric surgery. Materials and Methods This randomized, triple-blind, placebo-controlled clinical trial was conducted on patients with food addiction and weight regain after metabolic bariatric surgery. Participants ( n  = 50) received a weight loss program and CBT plus probiotic, or placebo for 12 weeks. Then, anthropometric measurements, biochemical markers, eating behavior, and food addiction were assessed. Results Weight and body mass index (BMI) decreased significantly in the probiotic group compared to placebo ( p  = 0.008, p  = 0.001, respectively). Fat mass was significantly decreased in the probiotic group ( p  < 0.001). Moreover, a significant improvement was observed in the probiotic group’s eating behavior and food addiction compared to the placebo group ( p  < 0.001). Serum levels of leptin decreased significantly ( p  = 0.02), and oxytocin serum levels increased significantly ( p  = 0.008) in the probiotic group compared to the placebo group. Conclusion Adding probiotic supplements to the weight loss program and CBT is superior to the weight loss program and CBT alone in improving weight loss, eating behavior, and food addiction in patients with food addiction and weight regain after metabolic bariatric surgery. Graphical Abstract

IntroductionAddictive eating, a highly debated problematic eating behavior, may contribute to obesity and impede the success of individuals seeking bariatric surgery. The original Yale Food Addiction Scale (YFAS) was validated for use among patients who underwent bariatric surgery; however, the YFAS was revised to reflect changes in substance use criteria in the DSM-5. The purpose of this study was to validate the use of the revised measure, the YFAS 2.0, among patients pursuing bariatric surgery.MethodsA retrospective chart review was conducted of 314 patients who underwent pre-surgical psychological evaluation for bariatric surgery. Information gathered included symptoms of addictive eating (YFAS 2.0), emotional eating (Emotional Eating Scale; EES), and a history of substance use and binge eating.ResultsIn this sample, 27.3% met criteria for “food addiction” according to the YFAS 2.0. Of those, more than half met criteria for severe food addiction. The YFAS 2.0 was related to all factors of the EES: anger/frustration (p < .001); anxiety (p < .001); and depression (p < .001). There was no relationship between the YFAS 2.0 and a history of substance use. The YFAS 2.0 accounted for significant variance in history of binge eating after controlling for emotional eating (p < .001; Exp(B) = 1.30).ConclusionsResults were similar to a prior validation of the YFAS among a bariatric population, and the updated YFAS 2.0 may be useful in assessing addictive eating among bariatric surgery candidates to further explore the concept of “food addiction.”