Top

Obesity Surgery

Published in:

Open Access 01-05-2017 | Original Contributions

Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery—Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics

Authors: Tina Amundsen, Magnus Strømmen, Catia Martins

Published in: Obesity Surgery | Issue 5/2017

Abstract

Background

Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood.

Objectives

This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics.

Methods

Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL, <50%, n = 22) or SigWR (total weight regain ≥15%, n = 38), with respective control groups. Energy intake (EI) was measured with a Food Frequency Questionnaire, eating behavior using the Dutch Eating Behavior Questionnaire and the Three-Factor Eating Questionnaire, and PA using both SenseWear Armbands and the International Physical Activity Questionnaire. Eating disorders, depression, and quality of life (QoL) were measured using the Eating Disorder Examination Questionnaire, Beck Depression Inventory II, and Impact of Weight on Quality of Life, respectively.

Results

EI, macronutrient distribution, and meal frequency were similar among groups. However, disinhibited eating behavior score was higher, while most subcategories from IWQOL were significantly lower in both SWL and SigWR groups compared with their respective controls. PA was significantly lower in the SWL and SigWR groups compared with the respective controls. There were no differences between groups regarding depression.

Conclusions

Lower PA levels, disordered eating behavior and lower QoL are associated with unsuccessful weigh loss outcome after GB surgery. Longitudinal studies are needed to clarify the potential causal relationship between the previously described variables and SWL/SigWR after GB.

Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed

Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed

Julia C, Ciangura C, Capuron L, Bouillot JL, Basdevant A, Poitou C, et al. Quality of life after Roux-en-Y gastric bypass and changes in body mass index and obesity-related comorbidities. Diabetes Metab. 2013;39(2):148–54.CrossRefPubMed

Sweeney TE, Morton JM. Metabolic surgery: action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature. Best Pract Res Clin Gastroenterol. 2014;28(4):727–40.CrossRefPubMedPubMedCentral

Campos GM, Rabl C, Mulligan K, Posselt A, Rogers SJ, Westphalen AC, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143(9):877–83.CrossRefPubMedPubMedCentral

Melton GB, Steele KE, Schweitzer MA, Lidor AO, Magnuson TH. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastrointest Surg. 2008;12(2):250–5.CrossRefPubMed

Lutfi R, Torquati A, Sekhar N, Richards WO. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20(6):864–7.CrossRefPubMed

Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10(3):233–9.CrossRefPubMed

Higa K, Ho T, Tercero F, Yunus T, Boone KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25.CrossRefPubMed

10.

Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.CrossRefPubMed

11.

Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, Zaremba DL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.CrossRefPubMed

12.

Sarwer DB, Wadden TA, Moore RH, Baker AW, Gibbons LM, Raper SE, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.CrossRefPubMedPubMedCentral

13.

Fox B, Chen E, Suzo A, Jolles S, Greenberg JA, Campos GM, et al. Dietary and psych predictors of weight loss after gastric bypass. J Surg Res. 2015.

14.

Foster MT, Warne JP, Ginsberg AB, Horneman HF, Pecoraro NC, Akana SF, et al. Palatable foods, stress, and energy stores sculpt corticotropin-releasing factor, adrenocorticotropin, and corticosterone concentrations after restraint. Endocrinology. 2009;150(5):2325–33.CrossRefPubMed

15.

Petereit R, Jonaitis L, Kupcinskas L, Maleckas A. Gastrointestinal symptoms and eating behavior among morbidly obese patients undergoing Roux-en-Y gastric bypass. Medicina (Kaunas). 2014;50(2):118–23.CrossRef

16.

Laurenius A, Larsson I, Bueter M, Melanson KJ, Bosaeus I, Forslund HB, et al. Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass. Int J Obes. 2012;36(3):348–55.CrossRef

17.

Miras AD, Al-Najim W, Jackson SN, McGirr J, Cotter L, Tharakan G, et al. Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions. Scand J Surg. 2015;104(1):10–7.CrossRefPubMed

18.

Sanchez-Santos R, Del Barrio MJ, Gonzalez C, Madico C, Terrado I, Gordillo ML, et al. Long-term health-related quality of life following gastric bypass: influence of depression. Obes Surg. 2006;16(5):580–5.CrossRefPubMed

19.

Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord. 1998;22(2):113–26.CrossRefPubMed

20.

Andersen LF, Tomten H, Haggarty P, Lovo A, Hustvedt BE. Validation of energy intake estimated from a food frequency questionnaire: a doubly labelled water study. Eur J Clin Nutr. 2003;57(2):279–84.CrossRefPubMed

21.

Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985;29(1):71–83.CrossRefPubMed

22.

Van Strien T, Frijters JER, Bergers GPA, Defares PB. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord. 1986;5(2):295–315.CrossRef

23.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed

24.

Gradaschi R, Camerini G, Carlini F, Sukkar S, Sopinaro N, Adami GF. Physical activity after surgically obtained weight loss: study with a Sense Wear armband in subjects undergoing biliopancreatic diversion. Obes Surg. 2013.

25.

Unick JL, Bond DS, Jakicic JM, Vithiananthan S, Ryder BA, Roye GD, et al. Comparison of two objective monitors for assessing physical activity and sedentary behaviors in bariatric surgery patients. Obes Surg. 2012;22(3):347–52.CrossRefPubMedPubMedCentral

26.

Bond DS, Unick JL, Jakicic JM, Vithiananthan S, Pohl D, Roye GD, et al. Objective assessment of time spent being sedentary in bariatric surgery candidates. Obes Surg. 2011;21(6):811–4.CrossRefPubMedPubMedCentral

27.

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.CrossRefPubMed

28.

Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.PubMed

29.

Reas DL, Overas M, Ro O. Norms for the Eating Disorder Examination Questionnaire (EDE-Q) among high school and university men. Eat Disord. 2012;20(5):437–43.CrossRefPubMed

30.

Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. J Pers Assess. 1996;67(3):588–97.CrossRefPubMed

31.

Kolotkin RL, Crosby RD, Kosloski KD, Williams GR. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9(2):102–11.CrossRefPubMed

32.

Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc. 1995;Series B(57):289–300.

33.

Freire RH, Borges MC, Alvarez-Leite JI, Toulson Davisson Correia MI. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53–8.CrossRefPubMed

34.

Faria SL, de Oliveira KE, Lins RD, Faria OP. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20(2):135–9.CrossRefPubMed

35.

Welch G, Wesolowski C, Piepul B, Kuhn J, Romanelli J, Garb J. Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obes Surg. 2008;18(5):517–24.CrossRefPubMed

36.

Josbeno DA, Kalarchian M, Sparto PJ, Otto AD, Jakicic JM. Physical activity and physical function in individuals post-bariatric surgery. Obes Surg. 2011;21(8):1243–9.CrossRefPubMedPubMedCentral

37.

Mundi MS, Lorentz PA, Swain J, Grothe K, Collazo-Clavell M. Moderate physical activity as predictor of weight loss after bariatric surgery. Obes Surg. 2013;23(10):1645–9.CrossRefPubMed

38.

Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. American College of Sports Medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–71.CrossRefPubMed

39.

Warde-Kamar J, Rogers M, Flancbaum L, Laferrere B. Calorie intake and meal patterns up to 4 years after Roux-en-Y gastric bypass surgery. Obes Surg. 2004;14(8):1070–9.CrossRefPubMed

40.

Moize V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.CrossRefPubMed

41.

Laurenius A, Larsson I, Melanson KJ, Lindroos AK, Lonroth H, Bosaeus I, et al. Decreased energy density and changes in food selection following Roux-en-Y gastric bypass. Eur J Clin Nutr. 2013;67(2):168–73.CrossRefPubMed

42.

Kruseman M, Leimgruber A, Zumbach F, Golay A. Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010;110(4):527–34.CrossRefPubMed

43.

Mathus-Vliegen EMH. Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits. Int J Obes. 2006;31(2):299–307.CrossRef

44.

Burgmer R, Grigutsch K, Zipfel S, Wolf A, de Zwaan M, Husemann B, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg. 2005;15(5):684–91.CrossRefPubMed

45.

Hrabosky J, Masheb R, White M, Rothschild B, Burke-Martindale C, Grilo C. A prospective study of body dissatisfaction and concerns in extremely obese gastric bypass patients: 6- and 12-month postoperative outcomes. Obes Surg. 2006;16(12):1615–21.CrossRefPubMed

46.

Castellini G, Godini L, Amedei SG, Faravelli C, Lucchese M, Ricca V. Psychological effects and outcome predictors of three bariatric surgery interventions: a 1-year follow-up study. Eating and weight disorders: EWD. 2014;19(2):217–24.CrossRefPubMed

47.

Matini D, Ghanbari Jolfaei A, Pazouki A, Pishgahroudsari M, Ehtesham M. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery. Med J Islam Repub Iran. 2014;28:109.PubMedPubMedCentral

48.

Strain GW, Kolotkin RL, Dakin GF, Gagner M, Inabnet WB, Christos P, et al. The effects of weight loss after bariatric surgery on health-related quality of life and depression. Nutrition & diabetes. 2014;4:e132.CrossRef

49.

Kalarchian MA, King WC, Devlin MJ, Marcus MD, Garcia L, Chen JY, et al. Psychiatric disorders and weight change in a prospective study of bariatric surgery patients: a 3-year follow-up. Psychosom Med. 2015.

50.

Mitchell JE, King WC, Chen JY, Devlin MJ, Flum D, Garcia L, et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obesity (Silver Spring, Md). 2014;22(8):1799–806.CrossRef

51.

Faulconbridge LF, Wadden TA, Thomas JG, Jones-Corneille LR, Sarwer DB, Fabricatore AN. Changes in depression and quality of life in obese individuals with binge eating disorder: bariatric surgery versus lifestyle modification. Surg Obes Relat Dis. 2013;9(5):790–6.CrossRefPubMed

52.

Averbukh Y, Heshka S, El-Shoreya H, Flancbaum L, Geliebter A, Kamel S, et al. Depression score predicts weight loss following Roux-en-Y gastric bypass. Obes Surg. 2003;13(6):833–6.CrossRefPubMed

53.

Nadalini L, Zenti MG, Masotto L, Indelicato L, Fainelli G, Bonora F, et al. Improved quality of life after bariatric surgery in morbidly obese patients. Interdisciplinary group of bariatric surgery of Verona (G.I.C.O.V.). G Chir. 2014;35(7–8):161–4.PubMedPubMedCentral

Title: Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery—Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics
Authors: Tina Amundsen
Magnus Strømmen
Catia Martins
Publication date: 01-05-2017
Publisher: Springer US
Published in: Obesity Surgery / Issue 5/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-016-2475-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery—Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics

Abstract

Background

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2017

Colorectal Cancer Prognosis Following Obesity Surgery in a Population-Based Cohort Study

Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass

Simultaneous Liver Transplantation and Sleeve Gastrectomy: Prohibitive Combination or a Necessity?

The Role of Sleeve Gastrectomy in Reducing Cardiovascular Risk

National Differences in Remission of Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass Surgery-Subgroup Analysis of 2-Year Results of the Diabetes Surgery Study Comparing Taiwanese with Americans with Mild Obesity (BMI 30–35 kg/m2)

Erratum to: The Role of Sleeve Gastrectomy in Reducing Cardiovascular Risk