Skip to main content
Top
Published in: Obesity Surgery 9/2021

01-09-2021 | Bariatric Surgery | Original Contributions

Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study

Authors: Larissa Cristina Lins Berber, Mariana Silva Melendez-Araújo, Eduardo Yoshio Nakano, Kênia Mara Baiocchi de Carvalho, Eliane Said Dutra

Published in: Obesity Surgery | Issue 9/2021

Login to get access

Abstract

Background

Grazing behavior is common in patients undergoing bariatric surgery (BS); however, little is known about grazing behavior in operated patients in the long term. We aimed to estimate grazing frequency and its association with weight loss and surgery response in patients who had undergone BS.

Methods

This cross-sectional study included 109 patients who had undergone Roux-en-Y gastric bypass at least 5 years previously. They answered questions about socioeconomic factors, surgical information, and adherence to treatment/follow-up. The Rep(eat) questionnaire was used for grazing assessment. Student’s t-test and Pearson’s chi-square test were used to evaluate differences between groups. Analysis of covariance and partial correlation were used to investigate grazing behavior, and weight loss outcomes were controlled for the elapsed time since BS, healthcare service type, current psychologist care status, and the presence of a constriction ring.

Results

The mean elapsed time since BS was 9.97 ± 2.39 years. Patients with grazing behavior (67%) comprised fewer surgery responders (p = 0.019), had lower total (%TWL, p = 0.005) and excess weight loss (%EWL, p = 0.029), and received less psychological counseling (45.5% vs. 54.5%, p = 0.042). Correlations were found between the presence of grazing and its subtypes and %EWL and %TWL (T = − 0.382, T = − 0.361, p < 0.001; compulsive grazing: T = − 0.358, T = − 0.342, p < 0.001, p = 0.001; non-compulsive grazing: T = − 0.333, T = − 0.311, p = 0.001, p = 0.003). No significant difference between patients with and without grazing behavior was found for previous/current diagnoses of psychological diseases or dietitian counseling.

Conclusion

Grazing behavior is common in the long-term among patients who have undergone BS and is negatively related to weight loss parameters.

Graphical abstract

Literature
2.
go back to reference Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial-a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.CrossRef Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial-a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.CrossRef
3.
go back to reference Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRef Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRef
4.
go back to reference Conceição E, Teixeira F, Rodrigues T, et al. Problematic eating behaviors after bariatric surgery: a national study with a Portuguese sample. Acta Medica Port. 2018;31:633–40.CrossRef Conceição E, Teixeira F, Rodrigues T, et al. Problematic eating behaviors after bariatric surgery: a national study with a Portuguese sample. Acta Medica Port. 2018;31:633–40.CrossRef
5.
go back to reference Williams-Kerver GA, Steffen KJ, Mitchell JE. Eating pathology after bariatric surgery: an updated review of the recent literature. Curr Psychiatry Rep. 2019;21 Williams-Kerver GA, Steffen KJ, Mitchell JE. Eating pathology after bariatric surgery: an updated review of the recent literature. Curr Psychiatry Rep. 2019;21
6.
go back to reference Saunders R. Grazing: a high-risk behavior. 2004;98:102. Saunders R. Grazing: a high-risk behavior. 2004;98:102.
7.
go back to reference Pizato N, Botelho PB, Gonçalves VSS, et al. Effect of grazing behavior on weight regain post-bariatric surgery: a systematic review. Nutrients. 2017;9:1–12.CrossRef Pizato N, Botelho PB, Gonçalves VSS, et al. Effect of grazing behavior on weight regain post-bariatric surgery: a systematic review. Nutrients. 2017;9:1–12.CrossRef
10.
go back to reference Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity. 2008;16:615–22.CrossRef Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity. 2008;16:615–22.CrossRef
11.
go back to reference Lane B, Szabó M. Uncontrolled, repetitive eating of small amounts of food or “grazing”: development and evaluation of a new measure of atypical eating. Behav Chang. 2013;30:57–73.CrossRef Lane B, Szabó M. Uncontrolled, repetitive eating of small amounts of food or “grazing”: development and evaluation of a new measure of atypical eating. Behav Chang. 2013;30:57–73.CrossRef
12.
go back to reference Conceição EM, Mitchell JE, Machado PPP, et al. Repetitive eating questionnaire [Rep(eat)-Q]: enlightening the concept of grazing and psychometric properties in a Portuguese sample. Appetite. 2017;117:351–8.CrossRef Conceição EM, Mitchell JE, Machado PPP, et al. Repetitive eating questionnaire [Rep(eat)-Q]: enlightening the concept of grazing and psychometric properties in a Portuguese sample. Appetite. 2017;117:351–8.CrossRef
13.
go back to reference Heriseanu AI, Hay P, Touyz S. The short inventory of grazing (SIG): development and validation of a new brief measure of a common eating behaviour with a compulsive dimension. J Eat Disord. 2019;7:1–12.CrossRef Heriseanu AI, Hay P, Touyz S. The short inventory of grazing (SIG): development and validation of a new brief measure of a common eating behaviour with a compulsive dimension. J Eat Disord. 2019;7:1–12.CrossRef
14.
go back to reference Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity Nature Publishing Group. 2010;18:1938–43. Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity Nature Publishing Group. 2010;18:1938–43.
15.
go back to reference Mack I, Ölschläger S, Sauer H, et al. Does laparoscopic sleeve gastrectomy improve depression, stress and eating behaviour? A 4-year follow-up study. Obes Surg. 2016;26:2967–73.CrossRef Mack I, Ölschläger S, Sauer H, et al. Does laparoscopic sleeve gastrectomy improve depression, stress and eating behaviour? A 4-year follow-up study. Obes Surg. 2016;26:2967–73.CrossRef
18.
go back to reference Zarate X, Arceo-Olaiz R, Montalvo Hernandez J, et al. Long-term results of a randomized trial comparing banded versus standard laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9:395–7.CrossRef Zarate X, Arceo-Olaiz R, Montalvo Hernandez J, et al. Long-term results of a randomized trial comparing banded versus standard laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9:395–7.CrossRef
19.
go back to reference Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRef Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.CrossRef
20.
go back to reference Biron S, Hould FS, Lebel S, et al. Twenty years of biliopancreatic diversion: what is the goal of the surgery? Obes Surg. 2004;14:160–4.CrossRef Biron S, Hould FS, Lebel S, et al. Twenty years of biliopancreatic diversion: what is the goal of the surgery? Obes Surg. 2004;14:160–4.CrossRef
21.
go back to reference Pinto-Bastos A, Conceição E, de Lourdes M, et al. Psychological and behavioral aspects of primary and reoperative surgery: a 6-month longitudinal study. Obes Surg. 2018;28:3984–91.CrossRef Pinto-Bastos A, Conceição E, de Lourdes M, et al. Psychological and behavioral aspects of primary and reoperative surgery: a 6-month longitudinal study. Obes Surg. 2018;28:3984–91.CrossRef
22.
go back to reference Walø-Syversen G, Kvalem IL, Kristinsson J, et al. Preoperative inhibitory control predicts weight loss 1 year after bariatric surgery. Eur Eat Disord Rev. 2021;29:123–32.CrossRef Walø-Syversen G, Kvalem IL, Kristinsson J, et al. Preoperative inhibitory control predicts weight loss 1 year after bariatric surgery. Eur Eat Disord Rev. 2021;29:123–32.CrossRef
23.
go back to reference Conceição EM, Fernandes M, de Lourdes M, et al. Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eat Weight Disord. 2020;25:679–92.CrossRef Conceição EM, Fernandes M, de Lourdes M, et al. Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eat Weight Disord. 2020;25:679–92.CrossRef
24.
go back to reference Jumbe S, Hamlet C, Meyrick J. Psychological aspects of bariatric surgery as a treatment for obesity. Curr Obes Rep. 2017;6:71–8.CrossRef Jumbe S, Hamlet C, Meyrick J. Psychological aspects of bariatric surgery as a treatment for obesity. Curr Obes Rep. 2017;6:71–8.CrossRef
25.
go back to reference Morledge MD, Pories WJ. Mental health in bariatric surgery: selection, access, and outcomes. Obesity. 2020;28:689–95.CrossRef Morledge MD, Pories WJ. Mental health in bariatric surgery: selection, access, and outcomes. Obesity. 2020;28:689–95.CrossRef
27.
go back to reference Conceição EM, de Lourdes M, Pinto-Bastos A, et al. Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: the mediating role of loss of control eating. Int J Eat Disord. 2018;51:507–17.CrossRef Conceição EM, de Lourdes M, Pinto-Bastos A, et al. Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: the mediating role of loss of control eating. Int J Eat Disord. 2018;51:507–17.CrossRef
28.
go back to reference Goodpaster KPS, Marek RJ, Lavery ME, et al. Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates. Surg Obes Relat Dis Elsevier. 2016;12:1091–7.CrossRef Goodpaster KPS, Marek RJ, Lavery ME, et al. Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates. Surg Obes Relat Dis Elsevier. 2016;12:1091–7.CrossRef
29.
go back to reference Marshall S, Mackay H, Matthews C, et al. Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post-operative weight loss, co-morbidities, and quality of life? A systematic review and meta-analysis. Obes Rev. 2020;21:1–14.CrossRef Marshall S, Mackay H, Matthews C, et al. Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post-operative weight loss, co-morbidities, and quality of life? A systematic review and meta-analysis. Obes Rev. 2020;21:1–14.CrossRef
30.
go back to reference Adler S, Fowler N, Robinson AH, et al. Correlates of dietary adherence and maladaptive eating patterns following Roux-en-Y bariatric surgery. Obes Surg. 2018;28:1130–5.CrossRef Adler S, Fowler N, Robinson AH, et al. Correlates of dietary adherence and maladaptive eating patterns following Roux-en-Y bariatric surgery. Obes Surg. 2018;28:1130–5.CrossRef
32.
go back to reference Voorwinde V, Steenhuis IHM, Janssen IMC, et al. Definitions of long-term weight regain and their associations with clinical outcomes. Obes Surg. 2020;30:527–36.CrossRef Voorwinde V, Steenhuis IHM, Janssen IMC, et al. Definitions of long-term weight regain and their associations with clinical outcomes. Obes Surg. 2020;30:527–36.CrossRef
33.
go back to reference Grover BT, Morell MC, Kothari SN, et al. Defining weight loss after bariatric surgery: a call for standardization. United States: Obes Surg; 2019. Grover BT, Morell MC, Kothari SN, et al. Defining weight loss after bariatric surgery: a call for standardization. United States: Obes Surg; 2019.
35.
go back to reference Pinto-Bastos A, de Lourdes M, Brandão I, et al. Weight loss trajectories and psychobehavioral predictors of outcome of primary and reoperative bariatric surgery: a 2-year longitudinal study. Surg Obes Relat Dis. 2019;15:1104–12.CrossRef Pinto-Bastos A, de Lourdes M, Brandão I, et al. Weight loss trajectories and psychobehavioral predictors of outcome of primary and reoperative bariatric surgery: a 2-year longitudinal study. Surg Obes Relat Dis. 2019;15:1104–12.CrossRef
Metadata
Title
Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study
Authors
Larissa Cristina Lins Berber
Mariana Silva Melendez-Araújo
Eduardo Yoshio Nakano
Kênia Mara Baiocchi de Carvalho
Eliane Said Dutra
Publication date
01-09-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 9/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05533-4

Other articles of this Issue 9/2021

Obesity Surgery 9/2021 Go to the issue