Grazing and Loss of Control Related to Eating: Two High-risk Factors Following Bariatric Surgery

Monash University, Centre for Obesity Research and Education (CORE), Alfred Hospital, Melbourne, Victoria, Australia.
Obesity (Impact Factor: 3.73). 03/2008; 16(3):615-22. DOI: 10.1038/oby.2007.101
Source: PubMed


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.
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.
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.
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.
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.

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    • "Such results have led to a rapid proliferation of lifestyle interventions in which persons undergoing weight loss surgery are increasingly expected to engage. By focusing on the importance of changing habits in terms of diet and exercise, such interventions are regarded as paramount to prevent weight regain in the long run (Colles, Dixon, & O'Brien, 2008; Hofsø et al., 2011; Sjöström et al., 2010).1 "
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    ABSTRACT: Background To prevent weight regain, patients undergoing weight loss surgery are encouraged to change their exercise and dietary habits. Building on previous research, the aim of this study was to explore women's experiences of changing exercise habits – focusing on women participating in a group based rehabilitation program including surgical as well as non-surgical participants. Findings Based on interviews with the 11 women included in this study, as well as participant observation, two themes were identified; 1) Pushing ones tolerance limits, and 2) Rebutting the “quick fix” fallacy. Taken together, the findings showcase how being a part of this mixed group involved having to relate to social stigmas, as well as notions regarding successful and non-successful surgical outcomes. Although such notions may be useful in identifying potential challenges related to changing exercise habits, they do not illuminate the complexity of undergoing such changes following weight loss surgery. Conclusion The findings point to the need of acknowledging patients' own exceriences to determine how successful they are after surgery. Given the findings, I argue for the need to reconsider the notion of success in relation to group based interventions.
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    • "The present results show that grazing behaviour is in fact associated with a perception of loss of control over eating. Further , this perception is not only present in extreme obese patients opting for bariatric surgery (Colles et al., 2008; Kofman et al., 2010; Saunders, 2004), but it can also be observed in a healthy young adult sample of university students. Nevertheless, a two-factor solution underlying participants' responses to the Grazing Questionnaire suggests that, at least in a young, normal-weight population, some individuals do "
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