Early Changes in Observed Eating Behaviours and Suboptimal Weight Loss in Gastric Bypass Patients: Preliminary Findings †
by
, , , , , and
Heather Spence
1
,
Alexander Miras
2,
Julie Sittlington
1,
Carel Le Roux
3
,
Alan Spector
4,
Maeve A. Kerr
1,
Chris I. R. Gill
1,
Zsolt Bodnar
5,
David Daniel Kerrigan
6,
Dimitri J. Pournaras
7,
M. Barbara E. Livingstone
1 and
Ruth K. Price
1,* 1
Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine BT52 1SA, UK
2
School of Medicine, Ulster University, Londonderry BT48 7JL, UK
3
Diabetes Complications Research Centre, Conway Institute, University College Dublin, D04 V1W8 Dublin, Ireland
4
Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
5
Department of Surgery, Letterkenny University Hospital, F92 AE81 Donegal, Ireland
6
Phoenix Health, Chester CH1 6LT, UK
7
Department of Bariatric and Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK
*
Author to whom correspondence should be addressed.
†
Presented at the 14th European Nutrition Conference FENS 2023, Belgrade, Serbia, 14–17 November 2023.
Proceedings 2023, 91(1), 113; https://doi.org/10.3390/proceedings2023091113
Published: 13 December 2023
(This article belongs to the Proceedings of The 14th European Nutrition Conference FENS 2023)
Bariatric surgery is the most effective long-term treatment for severe obesity [1], however despite excellent results being obtained at the group level, the response and durability of weight loss after surgery is heterogeneous and a proportion of patients may experience suboptimal weight loss (SWL) [2]. The mechanisms underlying SWL are poorly understood but may be linked to eating behaviours [2].
The aim of this work was to identify if early changes in energy intake (EI) and eating behaviours at 1-year are associated with long-term weight outcomes 5-years post-surgery. Twenty-two patients, after gastric bypass (gender: 18 F, 82.0%, 46.2 ± 1.6kg/m2, 46.1 ± 2.6 years), attended residential research appointments pre-surgery (−1 month) and at 12- and 60-months post-surgery. At each time point, EI (MJ) and eating behaviours (dietary energy density, eating speed, and number, size and duration of eating occasions) were determined over a 24-h period using the covert weighing of food and validated via closed circuit television. Body composition was measured using dual-energy X-ray absorptiometry and the percentage of total weight loss (%TWL) used to distinguish between patients who had suboptimal (<15% TWL) and patients with optimal weight loss (15–25%, or, >25% TWL) at 5 years post-surgery.
Briefly, 5 patients experienced SWL (−9.2 ± 1.8%), while 7 patients experienced 15–25% TWL (−21.9 ± 1.4%), and 10 patients experienced >25% TWL (−35.0 ± 1.8%). There were no differences in EI or dietary energy density between the three groups at baseline, or percentage changes at 1-year post-surgery (ANOVA; p > 0.54 and p > 0.48, respectively). Those experiencing SWL did not change their eating speed post-surgery, whilst those with optimal weight loss (>25%) reduced their eating speed (+7.2 ± 0.53, +133.8 ± 0.53%, −18.9 ± 21.2%, for SWL [<15%], 15–25% and >25% TWL; p= 0.01). Those with optimal weight loss also decreased their EI per eating occasion at 1 year (−53.2 ± 2.8%, +88.9 ± 105.0%, −57.8 ± 6.9%, for SWL [<15%], 15–25% and >25% for TWL; p = 0.01). These findings indicate that targeting interventions to the stratum of patients with such eating behaviours could enhance weight loss. Further work is required to verify findings and identify other modifiable eating behaviours in those most at risk of SWL.
Author Contributions
Conceptualization, R.K.P., M.B.E.L., C.L.R. and A.S.; Formal analysis, H.S.; investigation, H.S., A.M., J.S., C.L.R., A.S., M.A.K., C.I.R.G., M.B.E.L. and R.K.P.; writing—original draft preparation, H.S.; writing—review and editing, H.S., A.M., J.S., C.L.R., A.S., M.A.K., C.I.R.G. and R.K.P.; visualization, A.M., J.S., C.L.R., A.S., M.A.K., C.I.R.G., M.B.E.L., R.K.P., Z.B., D.D.K. and D.J.P.; supervision, A.M., J.S., C.L.R., M.A.K., C.I.R.G. and R.K.P.; funding acquisition, R.K.P., C.L.R. and A.S. All authors have read and agreed to the published version of the manuscript.
Funding
US-Ireland Research and Development Partnership program, Grant/Award Number: R01-DK106112-01A1; National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, Grant/Award Number: R01DK106112; Health Research Board of the Republic of Ireland, Grant/Award Number: USIRL-2006; Medical Research Council, UK, Grant/Award Number: MC_PC_16017; Health and Social Care R&D Division of Northern Ireland, Grant/Award Number: STL/5062/14. This trial was registered as clinicaltrials.gov as NCT03113305.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of Research Ethics Committee 3, West of Scotland (16/WS/0056, date of approval: 04/03/2016).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
Data described in the abstract will be made available upon request pending application and approval.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Akalestou, E.; Miras, A.D.; le Roux, C.W. Mechanisms of weight loss after obesity surgery. Endocr. Rev. 2022, 43, 19–34. [Google Scholar] [CrossRef] [PubMed]
- Amundsen, T.; Strømmen, M.; Martins, C. Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery-Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics. Obes. Surg. 2017, 27, 1316–1323. [Google Scholar] [CrossRef] [PubMed]
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MDPI and ACS Style
Spence, H.; Miras, A.; Sittlington, J.; Le Roux, C.; Spector, A.; Kerr, M.A.; Gill, C.I.R.; Bodnar, Z.; Kerrigan, D.D.; Pournaras, D.J.; et al. Early Changes in Observed Eating Behaviours and Suboptimal Weight Loss in Gastric Bypass Patients: Preliminary Findings. Proceedings 2023, 91, 113. https://doi.org/10.3390/proceedings2023091113
AMA Style
Spence H, Miras A, Sittlington J, Le Roux C, Spector A, Kerr MA, Gill CIR, Bodnar Z, Kerrigan DD, Pournaras DJ, et al. Early Changes in Observed Eating Behaviours and Suboptimal Weight Loss in Gastric Bypass Patients: Preliminary Findings. Proceedings. 2023; 91(1):113. https://doi.org/10.3390/proceedings2023091113
Chicago/Turabian StyleSpence, Heather, Alexander Miras, Julie Sittlington, Carel Le Roux, Alan Spector, Maeve A. Kerr, Chris I. R. Gill, Zsolt Bodnar, David Daniel Kerrigan, Dimitri J. Pournaras, and et al. 2023. "Early Changes in Observed Eating Behaviours and Suboptimal Weight Loss in Gastric Bypass Patients: Preliminary Findings" Proceedings 91, no. 1: 113. https://doi.org/10.3390/proceedings2023091113
