Changes in Eating Behavior After Laparoscopic Adjustable Gastric Banding: A Systematic Review of the Literature

Abstract

This systematic review evaluates the current evidence base for eating behavior changes after laparoscopic adjustable gastric banding (LAGB). A literature search from 1990 to February 2010 was conducted to identify original studies that assessed eating behavior in adults who have undergone LAGB. Sixteen articles (14 separate studies) met inclusion criteria. Although strength of the evidence base was limited by observational study designs and methodological weaknesses, results suggest that positive changes in eating behavior occur after surgery, including reduced over-eating in response to emotional and situational cues. There is some evidence to suggest that uncontrolled eating behaviors persist in some individuals, and that this may be problematic for weight loss after surgery. Few studies examined the relationship between changes in eating behavior and weight loss; thus, optimal behavioral strategies for promoting positive weight outcomes remain unclear. Further interventional research addressing the inherent limitations of the current-evidence base is required to guide development of evidence-based management guidelines for LAGB in future.

Patients’ expectations and experiences of eating behaviour change after bariatric procedures

“…Our results are consistent with previous findings that positive eating‐related change does not always occur, or persist, after bariatric procedures, and support previous assertions that 1 to 2 years post‐surgery is a significant time period for the occurrence or reoccurrence of eating‐related difficulties . In our study, the same percentages reported that their disordered eating behaviours had improved or resolved as said these had instead persisted or emerged post‐surgery.…”

“…However, patients do not always have desired, healthy or helpful eating‐related experiences after bariatric surgery, and initial positive changes may not persist in the medium‐ or long‐term . For example, we noted reports of binge eating reoccurring or beginning de novo after bariatric surgery, often at one to 2 years post‐surgery .…”

“…Post‐surgical eating‐related change has also been shown to differ depending on the bariatric surgery undergone . Despite the common bariatric procedures involving differing physiological alterations, mechanisms of change, average weight losses, failure and weight regain rates and improvements in obesity‐related health conditions , most reviews of eating behaviour change after bariatric surgery have examined either a single procedure or multiple procedures under a single ‘bariatric surgery’ banner .…”

Postoperative Behavioral Variables and Weight Change 3 Years After Bariatric Surgery

“…After LAGB, it has been shown that decreased hunger and disinhibition, 20 better dietary compliance, 7 improved eating behavior and changes to healthier eating patterns, 21,29 less “nonhunger” eating, 30 and less “uncontrolled eating” 30 are associated with better weight loss outcomes. 31 Also, a recent report from the Swedish Obese Subjects study found that participants who had lower levels of disinhibition and hunger at 6 months and 1 year lost more weight at 2-, 6-, and 10-year follow-up. 32 While most of these studies have been of modest sample size, usually 200 participants or fewer, there have been exceptions with larger sample sizes.…”

The Relationship of Eating Behaviors, Hunger Control, and Physical Activity to Weight Loss and Quality of Life in Laparoscopic Adjustable Gastric Banding Patients

“…However, a recent systematic review suggests that although uncontrolled eating behaviors may persist in some patients after surgery, in the majority of banding patients, overeating behaviors were reduced. It is speculated that reduction in overeating is related to the restrictive nature of the band [27].…”