title: Postoperative grazing as a risk factor for negative outcomes after bariatric surgery.
abstract: OBJECTIVE
  After bariatric surgery, de novo eating patterns can develop, such as grazing. Although grazing has been associated with poorer weight loss, it has received minimal attention. We aimed to assess the influence of grazing in clinical, biochemical and psychological outcomes in a bariatric surgery sample.
  
  
  METHODS
  Sixty patients (78.3%♀, age 46.35±9.89, months since BS 46.28±18.1) who underwent BS were evaluated cross-sectionally. Clinical, biochemical and psychological parameters were recorded. A pattern of grazing was assessed in this group of patients through interview.
  
  
  RESULTS
  41.7% met criteria for grazing. Mean time since BS was greater in the group with grazing (57.64±23.7months vs 38.8±26.44months; p=0.008). Although there were no differences in initial and current BMI, the percentage of patients with weight regain was greater among patients with grazing (72% vs 11.7%; p<0.0001) and the percentage of excess weight loss was lower (28.15±6.96% vs 33.35±11.9%; p=0.05). There were more difficulties in following the standardized visits according to our hospital's protocol (17.6% vs 56%; p=0.009). No significant differences were found when assessing presurgical psychiatric comorbidity among patients with a grazing pattern and individuals without this condition (68% vs 55.9%; p=0.423). When assessing quality of life only mental health was lower among patients with grazing (49.6±22.7 vs 64.2±23.3; p=0.02).
  
  
  CONCLUSIONS
  Development of grazing is frequent after BS, especially when weight loss has reached a plateau. Due to its potential association with weight regain, systematic screening of grazing after BS is warranted.
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Palma de Mallorca, Spain. Electronic address: jnicolauramis@gmail.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Nicolau
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: Ayala
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Rosmeri
authors.initials: R
authors.lastname: Rivera
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Speranskaya
authors.affiliation: Research Unit, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Sanchís
authors.affiliation: Surgery Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Julian
authors.affiliation: Hormonal Laboratory Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Regina
authors.initials: R
authors.lastname: Fortuny
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Masmiquel
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Grazing; Obesity; Quality of life; Weight loss