Grazing and Loss of Control Related to Eating: Two High-risk Factors Following Bariatric Surgery
Article first published online: 6 SEP 2012
2008 North American Association for the Study of Obesity (NAASO)
Volume 16, Issue 3, pages 615–622, March 2008
How to Cite
Colles, S. L., Dixon, J. B. and O'Brien, P. E. (2008), Grazing and Loss of Control Related to Eating: Two High-risk Factors Following Bariatric Surgery. Obesity, 16: 615–622. doi: 10.1038/oby.2007.101
- Issue published online: 6 SEP 2012
- Article first published online: 6 SEP 2012
- Received for review May 30, 2007, Accepted in final from August 27, 2007
Background: Gastric restrictive surgery induces a marked change in eating behavior. However, the relationship between preoperative and postoperative eating behavior and weight loss outcome has received limited attention.
Objective: This study assessed a range of eating behaviors before and 1 year after laparoscopic adjustable gastric banding (LAGB) and explored the nature and extent of change in eating patterns, their clinical associates, and impact on weight loss.
Methods and Procedures: A 12-month observational study assessed presurgical and postsurgical binge eating disorder (BED), uncontrolled eating, night eating syndrome (NES), grazing, nutrient intake and eating-related behaviors, and markers of psychological distress. A total of 129 subjects (26 male and 103 female, mean age 45.2 ± 11.5 and BMI 44.3 ± 6.8) participated in this study.
Results: Presurgical BED, uncontrolled eating, and NES occurred in 14%, 31%, and 17.1% of subjects, which reduced after surgery to 3.1%, 22.5%, and 7.8%, respectively (P = 0.05 for all). Grazing was prevalent before (26.3%) and after surgery (38.0%). Preoperative BED most frequently became grazers (P = 0.029). The average percentage weight loss (%WL) was 20.8 ± 8.5%; range −0.67 to 50.0% and percentage of excess weight loss (%EWL) 50.0 ± 20.7%; range −1.44 to 106.9% (P < 0.001). Uncontrolled eating and grazing after surgery showed high overlap and were associated with poorer %WL (P = 0.008 and P < 0.001, respectively) and elevated psychological distress.
Discussion: Consistent with recent studies, uncontrolled eating and grazing were identified as two high-risk eating patterns after surgery. Clearer characterization of favorable and unfavorable postsurgical eating behaviors, reliable methods to assess their presence, and empirically tested postsurgical intervention strategies are required to optimize weight loss outcomes and facilitate psychological well-being in at-risk groups.