Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre‐post studies

Abstract

Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours.

Medical nutrition therapy for post-bariatric hypoglycemia: practical insights

“…For example, frequent eating outside the home or takeout meals, skipping meals, drinking with meals, drinking sweetened beverages, alcohol intake, and a diet high in added sugar are common prior to surgery. Moreover, disordered eating/eating disorders, such as binge eating, emotional eating, and bulimia may have been present before surgery and persist to some extent after surgery [40], making dietary changes more challenging. After surgery, patients sometimes forget to separate beverages from foods, or may form a new habit of using liquid protein supplements as a major source of food.…”

Psychosomatic and Psychosocial Questions Regarding Bariatric Surgery: What Do We Know, or What Do We Think We Know?

“…In terms of the association between pre-and postoperative eating behavior and its predictive function for the postoperative weight change, the postoperative eating behavior emerges as having clearly greater predictive value (Opozda et al, 2016). However, it is difficult to predict, which individual patient will re-develop binge eating after surgery.…”

“…Studies with longer follow-ups have reached divergent results (Karlsson et al 2008;Herpertz et al 2015;Canetti et al 2016). There is also mounting evidence that patients who still have psychological problems after the operation or who re-develop mental health problems have a worse long-term weight loss outcome Sheets et al 2015;Opozda et al 2016). However, particularly with regard to depression, there is still some controversy in terms of the directionality of this relationship.…”

“…The amounts of food which are consumed during a binge episode, however, are generally smaller than before the operation, particularly after restrictive procedures. Patients with a preoperative eating disorder carry a greater risk of problematic eating behavior after the operation (Niego et al 2007;Opozda et al 2016), which is in turn associated with a lower weight reduction or higher weight increase. For instance, Colles et al (2008) examined 129 obese patients before and one year after bariatric surgery.…”

“…These include night-eating syndrome (NES) (Allison et al 2006), in which approx. 75% of the daily calorie intake is consumed in the evening and night and nighttime binge episodes occur; "grazing," which refers to the consumption of small amounts of food spread across the day without a feeling of hunger (Colles et al 2008); loss of control over eating (LOC); emotional eating; eating without hunger; or addictive eating behavior (Opozda et al 2016;Baldofski et al 2015). After bariatric surgery, eating disorders decrease in short-term, but appear to increase again over time.…”