Elsevier

Surgery for Obesity and Related Diseases

Volume 9, Issue 6, November–December 2013, Pages 942-948
Surgery for Obesity and Related Diseases

Integrated health article
Original article
Factor structure and predictive utility of the Binge Eating Scale in bariatric surgery candidates

https://doi.org/10.1016/j.soard.2012.06.013Get rights and content

Abstract

Background

Screening for binge eating before bariatric surgery is a component of the recommended clinical practice for bariatric surgery candidates. The Binge Eating Scale (BES) is 1 of the most commonly used self-report measures of eating behaviors in preoperative evaluations; however, the factor structure of this measure has not been evaluated in the bariatric population. The aims of the present study were to report the mean, standard deviation, and reliability of the BES for patients seeking bariatric surgery; to evaluate the 2-factor structure of the BES using confirmatory factor analysis; and to investigate the association between the BES and its factors with surgical weight loss. The setting was an academic medical center.

Methods

A total of 530 patients completed the BES as a component of their psychological evaluation before undergoing Roux-en-Y gastric bypass surgery.

Results

Approximately one third of patients reported at least mild to moderate binge eating, with 9% of patients reporting severe binge eating on the BES. The BES demonstrated good internal consistency. The results of the confirmatory factor analysis indicated that a 2-factor structure, consisting of feelings/cognitions related to binge eating and behavioral manifestations of binge eating, was the best fit to the data. Nonsignificant correlations were found between the BES and its 2 factors with short-term postoperative weight loss.

Conclusion

The BES measures 2 aspects of binge eating in bariatric surgery candidates, feelings/cognitions and behavioral manifestations of binge eating. Consideration of these factors in patients presenting for bariatric surgery could allow for a more detailed understanding of binge eating in this population.

Section snippets

Participants

The participants were 530 consecutive patients presenting for psychological evaluation before undergoing Roux-en-Y gastric bypass at an urban academic medical center. Most participants (84.0%) were women, with a BMI of 34.9–84.4 kg/m2 (mean 50.7 ± 9.2) and age range of 18–67 years (mean 41.9 ± 10.4). Approximately one half of the participants (52.3%) were black, 36.6% were white, and 9.4% were Hispanic.

Binge Eating Scale

Each of the 16 items of the BES contains 3–4 response options, reflecting a range of severity

BES Descriptives

The mean total score for the BES was 13.4 ± 8.5 (range 0–39). The distribution of responses within the established cutoffs was 67% “absent to minimal binge eating” (score 0–17), 24% “mild to moderate binge eating” (score 18–26), and 9% “severe binge eating” (score >26). In this sample, Cronbach's α for the total score was .87, indicating good internal consistency.

Factor structure of the BES

First, we specified a base model against which several alternative nested models were evaluated. The fit statistics of all models

Discussion

The results of the present study suggest that the BES is a reliable measure that identifies approximately one third of patients seeking bariatric surgery at an urban medical center as having at least mild to moderate self-reported binge eating behaviors or cognitions. Notably, this number might underrepresent the true presence of binge eating in this population, because there is the potential for socially desirable responding in patients presenting for a required psychological evaluation. A

Conclusion

Because the original BES scale development report did not specify the item assignment for each binge eating component measured by the scale, we recommend additional evaluation of the factor structure of the BES in other populations. Based on the empirical results from the present study, however, the BES does appear to measure feelings/cognitions and behaviors in bariatric surgery patients. If additional validation studies support this factor structure, this would support the interpretation of

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

Acknowledgment

Dr Hall’s contribution to this work was supported by NIMH Psychiatric Epidemiology Training Grant T32MH014592-35 (PI: Zandi).

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