A Higher Meal Frequency May be Associated with Diminished Weight Loss after Bariatric Surgery

Abstract

OBJECTIVEThis study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery.METHODSFemale patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome.RESULTSThe BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 and 35.4 ± 8.2 kg/m2, respectively. The corresponding choleric intakes were 535.6 ± 295.7, 677.1 ± 314.7 and 828.6 ± 398.2 kcal/day, and the numbers of daily meals were 5.0 ± 2.5, 4.7 ± 1.8 and 4.9 ± 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001).CONCLUSIONS1) Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2) vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.

Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass

“…However, it has also been demonstrated that frequent eating would be associated with poorer weight loss after RYGB. 49,50 These inconsistent results may be due to the snacks' size and content that might be of importance for weight status after RYGB in the same way as demonstrated in non-operated obese. 51 Behavioural and/or cognitive shifts may also contribute for the changes found in meal frequency, size and eating rate as suggested by other studies 20,21 as well as for weight loss and weight loss maintenance by non-surgical means.…”

Recommending Small, Frequent Meals in the Clinical Care of Adults: A Review of the Evidence and Important Considerations

“…Ribeiro and colleagues identified 80 obese women with narrowed gastric outlet after Roux‐en‐Y gastric bypass (RYGB) who were at risk for protein‐calorie malnutrition and Wernicke's encephalopathy 42 . In that prospective cohort study, the relationship between meal frequency and weight loss/vomiting was evaluated at 3‐month intervals for a total of 9 months after RYGB.…”

“…The study observed that, when compared with women who self‐reported consuming 3 meals per day, those who self‐reported consuming 6 meals per day had higher energy intakes at 3 months and lower weight loss postoperatively at 9 months. However, those self‐reporting more frequent meals also cited fewer vomiting episodes at 6 months, 42 suggesting that frequent meals may be an appropriate coping mechanism for vomiting and abdominal discomfort 42 …”

“…For example, experimental studies have used different meal frequencies when examining the benefits of frequent meals, including regimens of 5, 9, and 13 meals 12 , 19 , 38 . Whereas epidemiologic examinations have used a range of definitions to estimate meal frequency, such as combining the number of episodes per day (meal and snack eating) and further separating types of eating occasions (meals vs snacks) 13 , 14 , 42 . In these studies, frequencies >4 meals per day have typically been used to categorize individuals as “frequent eaters” and are often compared with ≤3 meals per day as the reference group.…”

Obesidade ante et post cirurgia

“…A segunda especialidade a ser empregue é o bypass, que segundo alguns especialistas é a prática ideal (Ribeiro et al, 2009;Hussain et al, 2009). Aliás, certos estudos demonstram que até ao momento a cirurgia mais utilizada é o bypass (Maggard et al, 2005).…”