Background

This study examined the prognostic significance of hedonic hunger in a treatment study of scalable adjunctive treatments for loss-of-control (LOC) eating delivered six months following bariatric surgery. Hedonic hunger refers to a powerful drive to eat highly tempting foods even in the absence of physiological hunger. This construct (relevant in our palatable food abundant society) has been linked with disordered eating, yet its prognostic utility remains unknown. 140 participants in a controlled treatment study examining 12-week scalable interventions for recurrent LOC-eating following bariatric surgery were assessed at baseline, post-treatment, and at 24-month follow-ups (33 months post-surgery) by independent assessors. 89% completed post-treatment assessments and 87% completed 24-month follow-ups. Hedonic hunger was assessed using the Power of Food Scale (PFS) at baseline and used to predict outcomes (LOC-eating frequency, percent weight loss, and depression) at post-treatment and at 24-month follow-up assessed using validated measures for the treatments overall (aggregated outcomes as they did not differ across treatments). Regression analyses revealed that baseline PFS scores significantly predicted LOC-eating frequency, eating-disorder psychopathology, and depression scores (p-values <.05), but not percent weight loss, at post-treatment and 24-month follow-up. Among participants with recurrent LOC-eating following bariatric surgery, greater hedonic hunger at the start of adjunctive treatments delivered 6-months postoperatively significantly predicted short- and longer-term psychosocial outcomes but not weight changes. Our findings suggest the importance of developing and integrating improved methods for coping with psychological drives to consume palatable foods in our society’s food-abundant environment into postoperative adjunctive interventions post-bariatric surgery.