Comparative Analysis of Bariatric Surgery Outcomes and Preoperative Body Composition in Obese Patients with Binge-Eating Disorders versus Simple Obesity Patients: A Retrospective Study

Objective To investigate the impact of binge eating disorder (BED) on metabolic parameters and body composition in obese individuals, examine the pathogenic connection between obesity and BED, and assess its possible influence on the results of weight loss surgery. Methods This retrospective analysis included 302 obese patients derived from the Western China Bariatric Surgery Cohort. The participants were divided into the BED group and the non-BED (NBED) group on the basis of the Binge Eating Scale (BES) questionnaire and DSM-V 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 The proportion of females was significantly greater (57.6% vs. 70.2%), and the BED group presented a greater body fat percentage (44.8% vs. 45.9%) and thigh fat mass (6.1 kg vs. 6.5 kg) (all P < 0.05) but a lower muscle-to-fat ratio (men 0.81 vs. 0.84; women 0.60 vs 0.64) and basal metabolic rate per unit body weight (men 15.6 kcal vs 15.9 kcal; women 15.1 kcal vs 15.5 kcal). There was no statistically significant difference in weight loss between the two groups at 1 year and 2 years post-operatively (P > 0.05). Conclusion This study revealed that obese patients with BED exhibit a unique metabolic phenotype characterized by a female predominance, regional fat accumulation (especially in the thigh area), and decreased energy metabolism efficiency. Lipotoxicity-mediated insulin resistance and chronic low-grade inflammatory states exacerbate metabolic disorders, and weight loss surgery has comparable short-term weight loss efficacy in obese BED patients and nonobese non-BED patients.