The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery

Afton M. Koball, Matthew M. Clark, Maria Collazo-Clavell, Todd Kellogg, Gretchen Ames, Jon Ebbert, Karen B. Grothe

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Background: Food addiction (FA) may be related to poor weight loss outcomes; however, the literature on food addiction in bariatric surgery-seeking populations is limited. Objectives: The aim of the present study was to identify the prevalence of FA in a bariatric surgery-seeking population and its association with mood, problematic eating behaviors, and substance use. The relationship between prebariatric surgery food addiction screening and postsurgical outcomes was assessed. Setting: Academic medical center. Methods: Adult outpatients (n = 923) seeking bariatric surgery underwent psychological evaluation between January 2012 and May 2014. Patients were administered the Yale Food Addiction Scale (YFAS) to assess FA. Of the original sample, 195 patients underwent Roux-en-Y gastric bypass surgery. Patients returned for medical follow-up at 6 (n = 169) and 12 (n = 113) months postsurgery; 26 (13%) patients at 6 months and 82 (42%) patients at 12 months were lost to follow-up or had not reached 1 year postsurgery. Results: Fourteen percent of patients met FA criteria. Patients positive for FA were more likely to endorse greater levels of depression, anxiety, binge eating episodes, nighttime eating syndrome, and low eating self-efficacy. No relationship was observed between FA and current substance use. FA did not predict postoperative outcomes including weight loss, rehospitalization, or attendance at follow-up medical appointments. Conclusions: FA is related to psychological distress and eating disordered behaviors among bariatric patients. However, FA was not predictive of short-term (6-12 mo) bariatric surgery outcomes. Future research should determine how FA affects long-term postoperative outcomes and mood stability.

Original languageEnglish (US)
Pages (from-to)165-170
Number of pages6
JournalSurgery for Obesity and Related Diseases
Issue number1
StatePublished - Jan 2016


  • Bariatric surgery
  • Food addiction

ASJC Scopus subject areas

  • Surgery


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