Changes in self-reported eating patterns after laparoscopic sleeve gastrectomy: a pre-post analysis and comparison with conservatively treated patients with obesity.
BACKGROUND
Patients with severe obesity need to adapt to surgically induced changes in their eating behaviors to maintain treatment success.


OBJECTIVE
This study examined the effects of laparoscopic sleeve gastrectomy (LSG) on weight loss and on 3 dimensions of eating behavior, namely, cognitive restraint, disinhibition, and hunger. Outcomes of the LSG group were compared with a group of conservatively treated (CT) patients, who underwent a 1-year multimodal weight-reduction group program that included dietary advice, physical exercise, psychoeducation, cognitive-behavioral therapy, training in Jacobson's progressive muscle relaxation, and social group support.


METHODS
The study setting was a multidisciplinary obesity center located in a university hospital.


METHODS
A sample of 102 patients with obesity were investigated using the Three-Factor Eating Questionnaire before and, on average, 19 (±5) months after weight loss intervention. Of the 102 patients, 62 (age 45.8±10.8 years, 71% females) underwent LSG, and 40 patients (age 50.6±11.3 years, 77.5% females) underwent the CT program. Patients were assigned to either the surgical or the nonsurgical intervention group following clinical guidelines and patient preference.


RESULTS
In the LSG group, total weight loss was 25.9±11.0%, excess weight loss was 52.8±24.1%, and body mass index decreased from 51.4±8.1 to 38.0±7.8 kg/m². In the CT group, total weight loss was 5.4±10.6%, excess weight loss was 13.9±27.1%, and body mass index decreased from 40.3±6.7 to 38.0±7.2 kg/m². Significant improvements in self-reported eating behaviors were observed in both groups, that is, an increased cognitive restraint of eating, a decreased disinhibition of eating control, and a reduced degree of perceived hunger. In contrast, whereas Three-Factor Eating Questionnaire scores before weight loss intervention did not differ between groups, LSG patients reported significantly greater reductions in disinhibition and hunger than CT patients did after weight loss intervention. In both groups, greater weight loss was associated with decreased hunger sensations.


CONCLUSIONS
In the second follow-up year, LSG was associated with greater weight loss and greater improvements in self-reported eating behaviors compared with conservative treatment.
Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany. Electronic address: andrea.figura@charite.de.
Andrea
A
Figura
Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany; Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655.
Matthias
M
Rose
Center for Obesity and Metabolic Surgery, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.
Jürgen
J
Ordemann
Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.
Burghard F
BF
Klapp
Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.
Anne
A
Ahnis
D000222:Adaptation, Physiological / Q000502:physiology; D000223:Adaptation, Psychological / Q000502:physiology; D050110:Bariatric Surgery / Q000379:methods; D016022:Case-Control Studies; D004038:Diet, Reducing / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D006815:Hunger / Q000502:physiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011182:Postoperative Care; D011613:Psychotherapy / Q000379:methods; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology; D061217:Weight Reduction Programs / Q000379:methods
Bariatric surgery; Eating behavior; Laparoscopic sleeve gastrectomy; Obesity; TFEQ; Treatment outcome; Weight loss intervention