Comparative analysis of bariatric surgery outcomes and preoperative body composition in individuals with obesity with and without binge-eating disorder: a retrospective study

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OBJECTIVE: To compare preoperative metabolic parameters and body composition in individuals with obesity with and without binge-eating disorder (BED), and to evaluate postoperative short-term weight-loss outcomes in these two groups in the absence of structured preoperative cognitive-behavioral therapy (CBT). METHODS: This retrospective analysis included 302 participants with obesity from the Western China Bariatric Surgery Cohort. Participants were classified into the BED group and the group without BED based on the Binge Eating Scale (BES) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria. Basal metabolic parameters were assessed via an InBody 770 body composition analyzer, and rigorous follow-up tracking of postoperative weight variations was performed. RESULTS: A total of 302 individuals with obesity were included, with 151 participants in the BED group and 151 in the group without BED. The proportion of females was significantly higher in the BED group than in the group without BED (p = 0.023). After adjustment for sex, there were no significant between-group differences in preoperative glucose, triglyceride, or total cholesterol levels. Sex hormone levels were comparable between groups in both males and females. Analysis of body composition showed no group differences in overall body weight, BMI, visceral fat area, or basal metabolic rate; however, females with BED exhibited greater leg fat mass (p = 0.037), while a trend toward a larger thigh circumference was observed among males (p = 0.050). In the linear mixed-effects model adjusted for sex and baseline weight, neither the main effect of group nor the group × time interaction was statistically significant, indicating comparable postoperative weight trajectories between the BED and NBED groups from baseline to 2 years after surgery. CONCLUSION: Individuals with obesity with and without BED showed largely comparable body-composition and metabolic characteristics. Bariatric surgery was associated with similar short-term weight-loss outcomes in individuals with obesity with and without BED, even in the absence of structured preoperative cognitive-behavioral therapy. These findings suggest that bariatric surgery may be an effective short-term weight-loss intervention for individuals with obesity and binge-eating disorder.

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