Objective: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in pre-bariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of the present study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor post-bariatric weight loss outcome. Methods: Within a prospective multicenter registry, N = 370 pre-bariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. Results: Five pre-bariatric subtypes were identified with specific profiles regarding self control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. Conclusion: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific pre-bariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for post bariatric weight loss and health-related outcomes.

Despite potentially severe medical consequences of pica and rumination disorder (RD), little is known about their prevalence and association with other psychopathology in childhood. As a part of a larger population-based study, 804 youths aged 7–14 years and their parents were asked about their experience of pica and RD behaviors, and associated eating, feeding and general psychopathology. A total of 12.31% and 11.49% of youth reported having engaged in pica or RD behaviors at least once. Recurring pica or RD behaviors had been experienced by 4.98% and 1.49% of the participants. The behaviors showed a significant, but small correlation with one another (r = .28, p < .01). Correlations with symptoms of avoidant/restrictive food intake disorder (ARFID) were significant, but small (pica: r = .18, RD: r = .27, both p < .01). Prevalence rates of recurring pica behavior were significantly increased if recurring RD was present (58.33%), and also greater vice versa (17.50%). The prevalence rates for recurrent pica and RD behaviors were also increased in the presence of an ARFID diagnosis (both behaviors 12.0%). However, correlations with restraint, eating, weight, and shape concern were nonsignificant (all p > .05). In addition, RD behavior was positively correlated with emotional and conduct problems (r = .15 and .22, both p < .01) and both behaviors were negatively correlated with prosocial behavior (r = −.10 and −.09, both p < .05). Our findings underscore the clinical significance of pica and RD behaviors. More research is warranted on both disorders, their association and their relation with ARFID, in order to reach a further understanding of their presentation and to ascertain diagnostic validity.

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.

Objective: The aim of this study was to develop, evaluate, and standardize a short form of the well-established Eating Disorder Examination-Questionnaire (EDE-Q). The newly developed EDE-Q8 was required to reflect the originally postulated structure of the EDE-Q. Method: Data were drawn from two nationwide representative population surveys in Germany: a survey conducted to develop the EDE-Q8 in 2009 (N = 2520); and a survey conducted in 2013 (N = 2508) for the evaluation and calculation of EDE-Q8 percentiles. Results: The EDE-Q8 had excellent item characteristics, very good reliability and a very good model fit for the postulated second-order factorial structure. Furthermore, a strong correlation between the EDE-Q8 and a 13 item short form of the Eating Attitudes Test was observed. Discussion: The EDE-Q8 appears to be particularly suitable in epidemiological research, when an economical assessment of global eating disorder psychopathology is required.

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.

Objective: The aim of this study was to develop, evaluate, and standardize a short form of the well-established Eating Disorder Examination-Questionnaire (EDE-Q). The newly developed EDE-Q8 was required to reflect the originally postulated structure of the EDE-Q. Method: Data were drawn from two nationwide representative population surveys in Germany: a survey conducted to develop the EDE-Q8 in 2009 (N = 2520); and a survey conducted in 2013 (N = 2508) for the evaluation and calculation of EDE-Q8 percentiles. Results: The EDE-Q8 had excellent item characteristics, very good reliability and a very good model fit for the postulated second-order factorial structure. Furthermore, a strong correlation between the EDE-Q8 and a 13 item short form of the Eating Attitudes Test was observed. Discussion: The EDE-Q8 appears to be particularly suitable in epidemiological research, when an economical assessment of global eating disorder psychopathology is required.