Risky Eating Behaviors after Bariatric Surgery

Gastric restrictive surgery has been a helpful procedure for many obese patients unable to lose weight by any other means. The relationship between eating behavior before and after bariatric surgery is just now beginning to be studied. Clinicians at the Centre for Obesity Research and Education at Alfred Hospital, Melbourne, Australia (Obesity January 17, 2008, Epub ahead of print), recently identified two high-risk behaviors after bariatric surgery.

Dr. S. J. Colles and co-workers assessed eating behaviors before and after laparoscopic adjustable gastric banding (LAGB), to assess any changes in eating patterns or clinical symptoms, and the impact upon weight loss. Over 12 months, they observed presurgical and postoperative binge eating disorder, uncontrolled eating, incidence of night eating syndrome, grazing, intake of nutrients, and eating related behaviors and markers of psychological distress among 129 patients (26 males and 103 female) who had undergone LAGB. The subjects’ average age was 45 years, and the average body mass index was 44 mg/kg2 before surgery.

Two risky behaviors after surgery

Uncontrolled eating and “grazing” were identified as high-risk behaviors after surgery. There was an overlap between both behaviors and both were associated with poorer long-term weight loss. The average percentage of weight lost was 20%, and 50% of excess weight was lost after the procedure. Before surgery, binge eating disorder, uncontrolled eating, and night eating syndrome were reported in 14%, 31%, and 17.1% of patients, respectively. After surgery these percentages fell to 3.1%, 22.5%, and 7.8%, respectively. Grazing, which affected 26.3% of the subjects before surgery, rose to involve 38.0% of patients after the procedure.

The authors note that other studies have also reported grazing and uncontrolled eating as problems after LAGB. They predict that empirically tested postsurgical intervention strategies will be needed to optimize weight loss outcome and to help improve psychological well-being among patients at risk.