A comparative study of eating behaviours within and between conventional metabolic (bariatric) surgery procedures

Abstract

Aims and objectives: To compare eating behaviours within and between gastric bypass, sleeve gastrectomy and gastric band procedures and to investigate associations between eating behaviours and body weight.

Background: Eating behaviours are subjective constructs representing physiological need and the hedonic need to eat. After metabolic surgery, eating behaviours have been observed to change. Little is known about whether eating behaviour change differs according to the metabolic procedure performed.

Design: Adults (n = 204) with severe obesity from three countries were followed 1 year after metabolic surgical procedures (n = 121).

Methods: We measured eating behaviours using the Three-Factor Eating Questionnaire and used linear mixed models to compare eating behaviours within and between three procedure groups. We complied with the STROBE checklist for reporting observational studies.

Results: Within groups, there were statistically significant increases in restraint and decreases in disinhibition and hunger. Between groups, we observed differences in disinhibition associated with the band procedure. There were no significant differences between any group for body weight or body mass index a year post-surgery. Disinhibition was the only eating behaviour associated with body weight, body mass index and the per cent of weight loss.

Conclusions: Eating behaviours in adults with severe obesity who underwent any of the three metabolic procedures were associated with eating behaviour change 1 year post-surgery. Disinhibition was the only eating behaviour that was associated with body weight.

Relevance to clinical practice: Irrespective of the procedure, we found participants had a statistically significant increase in restraint and decreases in disinhibition and hunger 1 year post-surgery. Despite the significant reduction in disinhibition within the band group, this behaviour was more pronounced post-surgery compared with other groups. Although the reduction in hunger showed the greatest change, it was not associated with weight outcomes. This is relevant clinical knowledge for nurses who support bariatric surgical patients.

Keywords: bariatric surgery; bariatric/surgical nursing; eating behaviours; evidence-based nursing; health education; interprofessional practice; nurse education; obesity; three-factor eating questionnaire.