Eating Behaviour Predicts Weight Loss Six Months after Bariatric Surgery: A Longitudinal Study

Abstract

Bariatric surgery is currently the most durable weight loss solution for patients with morbid obesity. The extent of weight loss achieved, however, is subject to variation due to various factors, including patients’ behaviour. In this study, we aimed to identify pre- and post-surgical predictors of weight loss following bariatric surgery. This prospective study included 57 participants who went through bariatric surgery (laparoscopic Roux-en-Y gastric bypass: n = 30; laparoscopic sleeve gastrectomy: n = 23; one anastomosis gastric bypass-mini gastric bypass: n = 4) in two tertiary referral hospitals. Consenting participants were assessed prior to surgery (T0), and three months (T1) and six months (T2) after surgery. The assessment included interview and anthropometric measurements. The interview was done with the aid of instruments, including the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression screening and the Dutch Eating Behaviour Questionnaire (DEBQ) for eating behaviour assessment. Baseline comorbidity status was obtained from medical records. A Generalised Estimating Equation (GEE) was developed to determine predictors of weight loss. Participants in the study were mostly women (n = 37, 65%) with a mean age of 39.4 (SD = 10.01) years. The mean excess BMI loss (EBMIL) and total weight loss (TWL) at the sixth month was 63.31% and 23.83%, respectively. Anxiety, depression, and external eating scores reduced over time. Advancing age, high BMI, and higher scores for emotional and external eating emerged as significant negative predictors for TWL%. It can be concluded that the patients experienced substantial weight loss after surgery. Continuous monitoring of psychological well-being and eating behaviour are essential for optimal weight loss.

Adjunctive liraglutide treatment in patients with persistent or recurrent type 2 diabetes after metabolic surgery (GRAVITAS): a randomised, double-blind, placebo-controlled trial

“…It is not possible to determine the direction of causality from this data: psychological morbidity could be contributing to suboptimal weight loss and glycaemic improvement or vice versa the suboptimal weight loss and diabetes relapse could be a cause of distress, anxiety and depression. Health related quality of life measures and measures of disordered eating were comparable with other studies of patients after bariatric surgery 29,30 . Eating behaviour appears to become healthier in terms of reduced preference and reward from palatable food after RYGB and VSG surgery 31 .…”

Eating Disorders and Obesity: The Challenge for Our Times

“…Bariatric surgery is the leading evidence-based approach in the treatment of obesity, but can it cause or exacerbate eating disorders through the inevitable state of imposed dietary restriction? In this Special Issue, Subramaniam et al [14] reported overall improvement in mental health and eating status six months post-surgery. However, poor mental health and eating prompted by external cues prior to surgery were associated with poorer outcomes post-surgery, highlighting the need to actively address mental health and eating behavior prior to surgery.…”

Is routine post-sleeve gastrografin needed? Profile of 98 cases

“…For example, Kavitha Subramaniam et al, in their prospective study that included 57 patients, the PWL was 23.68% (SD = 7.71). In fact, their study included patients who underwent either LSG or LRYGB, and for the patient who underwent LSG, the PWL was 19.84% (SD = 9.79); a figure notably lesser than the one found in KFSH bariatric centre [12]. We used PWS for reporting weight loss in our study because PWL was found to be the parameter least influenced by preoperative BMI.…”