Binge Eating and Addictive-Like Eating Behaviors Seven Years After Sleeve Gastrectomy: Implications for Long-Term Weight Loss Outcomes

INTRODUCTION: Binge eating (BE) and addictive-like eating behaviors, as assessed by the Yale Food Addiction Scale (YFAS) may change following metabolic bariatric surgery (MBS), yet their long-term trajectories and relationship with weight recurrence remain unclear. We examined their prevalence, longitudinal course, and associations with weight outcomes seven years following sleeve gastrectomy (SG). METHODS: Women who underwent primary SG (n = 62) were evaluated prospectively at baseline and at 3, 6, 12, and 24 months, and 7 years post-surgery. Addictive-like eating behaviors and BE were assessed using the YFAS and Binge Eating Scale (BES), respectively. Longitudinal changes and associations with 7-year weight recurrence from nadir were examined. RESULTS: Thirty women completed the 7-year follow-up. At baseline, addictive-like eating behaviors and BE were identified in 40.0% and 46.0% of participants, respectively. Prevalence declined at 6 months (addictive-like eating behaviors: 8.7%, BE: 10.6%), followed by a gradual increase by 7 years (addictive-like eating behaviors: 21.4%, BE: 26.9%). Baseline behaviors were not associated with weight recurrence at 7 years. In contrast, BE at 7 years was associated with greater weight recurrence from nadir (P = 0.015), whereas addictive-like eating behaviors were not. CONCLUSIONS: Although BE and addictive-like eating behaviors decline substantially during the early postoperative period following SG, both may gradually re-emerge over long-term follow-up. BE present at 7 years, but not addictive-like eating behaviors, was associated with significantly greater weight recurrence from nadir, underscoring the importance of sustained behavioral and psychological monitoring during long-term postoperative care.