Background: Bariatric surgery is an effective treatment for obesity, which is highly prevalent and associated with health complications. However, disordered eating, often coexisting with obesity, may remain unaddressed.
Aims: This study examined changes in disordered eating following bariatric surgery in an Australian cohort and identified associated demographic and psychosocial factors.
Methods: This prospective observational study followed participants from baseline (pre-surgery) and 6, 12 and 24 months post-bariatric surgery. Demographic data were obtained from clinician records and participant self-reports, while psychosocial data were assessed using self-report questionnaires, including the Eating Disorder Examination-Questionnaire (EDE-Q), the Assessment of Quality of Life, the Weight Bias Internalisation Scale, and the Depression Anxiety Stress Scale. Linear mixed model, linear regression, or Spearman’s rank correlation was used to examine associations and changes over time. Mediation analysis determined psychosocial variables that mediated changes in EDE-Q scores.
Results: Baseline median global EDE-Q score was 3.5 (IQR: 2.8 – 4.3) and decreased over 2 years, remaining lower at 24 months (B = -1.17, p < 0.001). Older age was associated with lower EDE-Q scores (B = -0.03, p < 0.001). Anxiety (F = 4.53, p = 0.034), internalised weight bias (F = 68.63, p < 0.001), and quality of life (F = 6.65, p = 0.01) predicted changes in EDE-Q global scores. Greater internalised weight bias (β = 0.53) and poorer quality of life (β = 0.14) predicted higher EDE-Q scores.
Conclusion: Disordered eating decreased post-bariatric surgery, and improvements were associated with better quality of life and reduced internalised weight bias, highlighting the importance of addressing weight stigma.