Grazing and Loss of Control Related to Eating: Two High‐risk Factors Following Bariatric Surgery

Abstract

background: Gastric restrictive surgery induces a marked change in eating behavior. However, the relationship between preoperative and postoperative eating behavior and weight loss outcome has received limited attention. objective: This study assessed a range of eating behaviors before and 1 year after laparoscopic adjustable gastric banding (LAGB) and explored the nature and extent of change in eating patterns, their clinical associates, and impact on weight loss. Methods and Procedures: A 12-month observational study assessed presurgical and postsurgical binge eating disorder (BED), uncontrolled eating, night eating syndrome (NES), grazing, nutrient intake and eating-related behaviors, and markers of psychological distress. A total of 129 subjects (26 male and 103 female, mean age 45.2 ± 11.5 and BMI 44.3 ± 6.8) participated in this study. Results: Presurgical BED, uncontrolled eating, and NES occurred in 14%, 31%, and 17.1% of subjects, which reduced after surgery to 3.1%, 22.5%, and 7.8%, respectively (P = 0.05 for all). Grazing was prevalent before (26.3%) and after surgery (38.0%). Preoperative BED most frequently became grazers (P = 0.029). The average percentage weight loss (%WL) was 20.8 ± 8.5%; range −0.67 to 50.0% and percentage of excess weight loss (%EWL) 50.0 ± 20.7%; range −1.44 to 106.9% (P < 0.001). Uncontrolled eating and grazing after surgery showed high overlap and were associated with poorer %WL (P = 0.008 and P < 0.001, respectively) and elevated psychological distress. Discussion: Consistent with recent studies, uncontrolled eating and grazing were identified as two high-risk eating patterns after surgery. Clearer characterization of favorable and unfavorable postsurgical eating behaviors, reliable methods to assess their presence, and empirically tested postsurgical intervention strategies are required to optimize weight loss outcomes and facilitate psychological well-being in at-risk groups.

Explaining the role of binge eating behaviour in weight loss post bariatric surgery

“…Latner & Wilson, 2002). In addition, studies have reported that BE behaviours can continue or develop postoperatively affecting weight loss outcome (Hsu, Betancourt & Sullivan,1996;Scholtz, Bidlake, Morgan, Fiennes, El-Etar, & Lacey, 2007) whereas others report a decrease or disappearance following surgery (Powers et al, 1999;White et al, 2006;Colles, Dixon, & O'Brien, 2008). Such conflictions may be the result of methodological issues such as poor study design, measurement error or sampling errors due to problems with sample sizes or may indicate that the role of eating behaviours in individuals undergoing obesity surgery is more complex than first thought.…”

Compulsão alimentar antes e após a cirurgia bariátrica

“…Não há consenso na literatura e dados precisos que garantam bom ou mau prognóstico adequadamente estudados e comprovados 14,25 . Os critérios de TCAP e episódios compulsivos precisam ser revisados e ampliados para que se obtenha mais precisão nas pesquisas e diagnósticos deste distúrbio 11 . Clareza na definição de comportamentos alimentares inadequados após opeação, métodos confiáveis para identificá-los e estratégias de intervenção pós-operatória são necessários para otimizar os resultados de perda de peso e promover o bem-estar psicológico dos pacientes.…”

Understanding Eating and Exercise Behaviors in Post Roux-en-Y Gastric Bypass Patients: A Quantitative and Qualitative Study

“…These finding are consistent with other WLS studies that report, in most cases of recidivism, weight loss failure is due to dietary noncompliance or an inability to change eating and exercise behaviors. [17][18][19][20][21][22] Findings from the Swedish Obesity Subjects study reported that baseline caloric intake was 2,800 calories. 35 At 6 months postsurgery, the study reported caloric intake at approximately 1,500 calories, and by 10 years postsurgery, the calorie intake had increased to an average of 1,800-2,000 calories per day.…”

“…[17][18][19][20]41,42 The study participants expressed in great detail their personal struggles with healthy food choices, managing stress, family and work environment support, and their overall perception of WLS outcomes. More education on food choices and more emotional support from family members, co-workers, support groups, and the medical community were identified as perceived needs to maintain weight and to prevent further weight gain.…”

“…[13][14][15][16] Many studies show that, in most cases of recidivism, weight loss failure is due to dietary noncompliance or an inability to change eating, social, and exercise behaviors. [17][18][19][20][21][22] Following WLS, individuals must learn to cope with internal and external eating behavior stimuli, including the family environment, food availability, and emotional stress that may lead to weight regain. 23 This represents the complex behavioral and environmental factors associated with weight maintenance and potential weight regain following WLS.…”