**Contributions of Emotional Overload, Emotion Dysregulation, and Impulsivity to Eating Patterns in Obese Patients with Binge Eating Disorder and Seeking Bariatric Surgery**

**Farid Benzerouk 1,2,\*, Zoubir Djerada 3, Eric Bertin 4, Sarah Barrière 1, Fabien Gierski 1,2,5 and Arthur Kaladjian 1,2**


Received: 30 August 2020; Accepted: 6 October 2020; Published: 12 October 2020

**Abstract:** Background: Binge eating disorder (BED) is very frequently observed in patients considered for weight loss surgery and seems to influence their outcome critically. Literature highlights a global emotional overload in individuals with BED, but little is known on the mechanisms involved. The present study aimed to focus on emotion regulation, impulsivity, depression, and anxiety in people with and without BED and fulfilling inclusion criteria for bariatric surgery. Doing so, we sought to individualize factors related to BED. Then, we examined the contribution of depression, anxiety, emotion regulation difficulties, and impulsivity to inappropriate eating behaviors observed in patients with BED. Methods: A sample of 121 individuals (79.3% female, mean age: 40.82 ± 9.26, mean current body mass index (BMI): 44.92 kg/m<sup>2</sup> <sup>±</sup> 7.55) seeking bariatric surgery were recruited at the Champagne Ardenne Specialized Center in Obesity in Reims, France from November 2017 to October 2018. They were stratified as with or without BED according to the binge eating scale. Characteristics identified in univariate analyses as differentiating the two groups were then included in multivariable analyses. Results: Multivariable analyses showed that limited access to emotional regulation strategies was significantly associated with BED. Furthermore, inappropriate eating behaviors were independently associated with age, depression severity, anxiety, emotional dysregulation, and impulsivity in BED group. Conclusions: The present findings are indicative of an association between emotion deficit and BED in obese patients seeking bariatric surgery. Patients with BED could benefit from the addition of an emotion regulation intervention.

**Keywords:** obesity; bariatric surgery; binge eating disorder; emotion dysregulation; emotional eating; external eating; strategies; non-acceptance; impulsivity
