Analysis of the Association between Eating Behaviors and Weight Loss after Laparoscopic Sleeve Gastrectomy

Obes Facts. 2019;12(6):618-631. doi: 10.1159/000502846. Epub 2019 Nov 20.

Abstract

Setting: In a private medical center, 300 patients who underwent a laparoscopic sleeve gastrectomy (LSG) were classified into 4 groups according to their eating behaviors (EB) preoperatively. During a 3-year postoperative follow-up, dietary changes in relation to weight loss were studied.

Objectives: To explore the influence of abnormal EB on the outcome of sleeve gastrectomy.

Background: Patients with morbid obesity often suffer from abnormal EB. After LSG, the outcome depends largely on improvement of the feeding behaviors acquired.

Methods: This prospective study includes 300 patients who underwent LSG from 2013 to 2014, divided into the following 4 groups: binge eaters, snack eaters, sweet eaters, and volume eaters.

Results: The average age was 41.65 years, the ratio of male to females was 1 to 2. The average baseline body mass index (BMI) was 42.02. After 3 years, no significant change was found in the number of binge eaters (p = 0.396), but there was an 8.9% increase in snack eaters (p < 0.001), a 12.9% increase in sweet eaters (p < 0.001), and 17.2% increase in healthy eating habits (p < 0.001). Sixty-five (24.8%) patients did not experience changes in their eating patterns. However, after surgery, 24.6% of the patients continued with the same EB and 125 (49.5%) patients changed from one EB to another unhealthy EB. Weight loss, measure as ΔBMI, was similar in each group after 3 years, with a mean BMI of 29.8. When eating habits were related to different features such as gender, sports practice, type of work, smoking, marital status, comorbidities, no influence on the operative results were found.

Conclusion: LSG promotes the reduction of overeaters; however, it promotes a switch between other unhealthy EB. The significant increase in snack eaters and sweet eaters is outstanding, although it did not affect weight loss in the midterm follow-up. Worsening of eating habits after LSG is a common fact.

Trial registration: ClinicalTrials.gov NCT02733562.

Keywords: Bariatric surgery; Binge eating disorders; Body mass index; Eating behavior; Weight loss.

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Comorbidity
  • Feeding Behavior / physiology*
  • Feeding and Eating Disorders / complications
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / surgery
  • Female
  • Follow-Up Studies
  • Gastrectomy* / methods
  • Gastrectomy* / rehabilitation
  • Humans
  • Laparoscopy / methods
  • Laparoscopy / rehabilitation
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Treatment Outcome
  • Weight Loss / physiology*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02733562