The food craving questionnaire-trait in a bariatric surgery seeking population and ability to predict post-surgery weight loss at six months Nina M. Crowley a, ⁎, Marie L. LePage b , Rachel L. Goldman c , Patrick M. O'Neil a , Jeffrey J. Borckardt a , T. Karl Byrne a a Medical University of South Carolina, 25 Courtenay Drive, Suite 7100A, MSC 290, Charleston, SC 29425, United States b Virginia Commonwealth University, Medical Center, West Hospital, 8th Floor, 1200 East Broad Street, Richmond, VA, 23298, United States c New York University Langone Medical Center, Bellevue Center for Obesity & Weight Management, 462 First Avenue, Amb Care Clinic 4D, New York, NY 10016, United States abstract article info Article history: Received 12 December 2011 Received in revised form 12 June 2012 Accepted 6 July 2012 Available online 16 July 2012 Keywords: Bariatric surgery Food craving Food Craving Questionnaire-Trait Predictor Weight loss Eating behavior Food cravings have been understudied in bariatric surgery patients and the Food Craving Questionnaire-Trait has not been validated in this population. Reliability and validity of the FCQ-T were examined and a regres- sion analysis was run to determine whether or not preoperative scores on individual subscales of the instru- ment could predict weight loss at 6 months. The FCQ-T demonstrated excellent internal consistency in bariatric surgery-seeking patients, and individual subscales measuring emotion and mood were correlated with other measures of depression and anxiety. Endorsement of binge eating or emotional eating behaviors during a clinical interview was correlated with similar subscales on the FCQ-T. Higher scores on the subscale ‘cues that may trigger food cravings’ were associated with greater weight loss at 6 months post-surgery and higher scores on the subscale ‘guilt from cravings and/or giving into them’ was associated with less weight loss. Management of external cues may predict successful outcomes while emotional impact of cravings may indicate the need for further intervention to help manage specific food craving traits. © 2012 Elsevier Ltd. All rights reserved. 1. Introduction Bariatric surgery is increasing in popularity, with approximately 220,000 bariatric surgeries performed in the USA and Canada in 2008, and 344,221 done worldwide (Buchwald & Oien, 2009). While patients can be expected to lose approximately 61% of their excess body weight in the two years following their surgery, 30–50% of patients regain some or all of the weight they initially lost (Magro et al., 2008). Moreover, it is estimated that 20% of patients will regain all of the initially lost weight (Benotti & Forse, 1995). There is tremendous interest in discovering psychological charac- teristics that patients who present for bariatric surgery possess which may be related to weight loss outcomes. After many reviews of the literature, it remains unclear which preoperative factors can be assessed to predict successful weight loss outcomes. Eating behavior disorders are suggested to be predictive of poor weight loss after bariatric surgery and binge eating disorder (BED) has been the primary eating disorder targeted. Preoperative rates of BED have been reported anywhere from 10% to 50% (Glinski, Wetzler, & Goodman, 2001; Kalarchian, Wilson, Brolin, & Bradley, 2000). There are mixed findings regarding the relationship between BED and weight loss after bariatric surgery. Some studies have found a relationship be- tween preoperative binge eating and less weight loss or weight regain within the first 2 years after gastric bypass (Hsu et al., 1998; Karlsson, Sjostrom, & Sullivan, 1998; Sallet et al., 2007). In the first six months after bariatric surgery, Dymek, le Grange, Neven, and Alverdy (2001) found that those with preoperative BED lost less weight than those without BED. However, several other studies have not found an associ- ation with binge eating and weight loss (Bocchieri-Ricciardi et al., 2006; Burgmer et al., 2009; Kinzl et al., 2006). Alger-Mayer, Rosati, Polimeni, and Malone (2009) conducted a prospective study to evaluate the pre- dictive ability of the preoperative assessment of eating disorders. Pa- tients with and without preoperative BED had similar weight loss at all time points up to six years after surgery. Although binge eating disorder has been extensively studied within this population and has been shown to have mixed predictive ability in respect to post-surgical weight loss, other eating behaviors (i.e. food cravings) have not received as much attention. Examining other eating behaviors that are not necessarily disordered in nature, but that are more commonly occurring and are associated with negative eating re- lated choices may allow researchers to identify new potential predictors of post-surgical weight loss. Food cravings are strong physiological or psychological desires that promote seeking and ingestion of a particular food (Cepeda-Benito, Gleaves, Williams, & Erath, 2000). Different from homeostatic hunger, food cravings are conceptualized as intense desires for specific foods that one makes extra efforts to obtain; while many foods can satisfy true hunger, only a specific food can satisfy a food crav- ing (Pelchat, 2002; Rabinovitz, 2005). Food cravings have been linked to snacking, non-compliance with dietary restrictions and weight-loss Eating Behaviors 13 (2012) 366–370 ⁎ Corresponding author. Tel.: +1 843 876 4307; fax: +1 843 876 4199. E-mail address: crowleyn@musc.edu (N.M. Crowley). 1471-0153/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.eatbeh.2012.07.003 Contents lists available at SciVerse ScienceDirect Eating Behaviors