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

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.

Conflict of interest statement

The authors declare no conflict of interests.

© 2019 The Author(s) Published by S. Karger AG, Basel.

Figures

Fig. 1

Questionnaire used to follow up eating habits after the surgery.

Fig. 2

Distribution of EB. a EB before the surgery. b Distribution of EB 3 years after the surgery. c Distribution of EB 3 years after the surgery in the binge-eating group. d Distribution of EB 3 years after the surgery in the snack-eating group. e Distribution of EB 3 years after the surgery in the sweet-eating group. f Distribution of EB 3 years after surgery in the overeating group.

Fig. 3

a Weight loss in 3 years. b Weight loss in 3 years according to eating habits.

Fig. 4

Tendency of less weight loss according to healthy eating habits (HEH) and numbers of eating habits. EH, eating habits.