Nutritional and behavioral factors related to weight gain after bariatric surgery

Abstract

Background: Weight regain (WR) after bariatric surgery is common. Several factors involved in WR have been identified, but there has been little research on specific eating habits such as eating snacks rather than regular meals and being a "sweet-eater". Aim: To determine whether nutritional status, energy and macronutrient intake, eating behaviors and habits were associated with WR in the postoperative period. Material and Methods: We conducted a case-control study of patients who had undergone bariatric surgery. Cases were defined as those patients who gained >= 15% of weight in the first two years after surgery and controls as those who gained < 15% of weight. Participants completed a 24-hour dietary recall by phone; weight history was obtained from the medical chart. Logistic regression was used to identify nutritional and behavioral factors significantly related to WR. Results: Fifty-four cases (77% female, 57% had undergone sleeve gastrectomy) and 50 controls (70% female, 58% had undergone Roux-en-Y gastric bypass surgery) participated. Their mean age was 43 and 40 years, respectively. We observed four eating and lifestyle habits independently associated with greater odds of post-surgery WR, namely being a "sweet-eater", a "grazer", sedentarism and consuming more daily calories. Conclusions: Eating more daily calories, being a "sweet-eater", a "grazer", and sedentarism were factors related with a greater risk of regaining weight after surgery.

La ganancia de peso después de la cirugía bariátrica es común. Se han identificado varios factores involucrados en la recuperación de peso, pero existe poca evidencia sobre hábitos alimentarios específicos tales como el patrón picoteador o ser un comedor de dulces. Objetivo: Determinar si el estado nutricional, ingesta calórica y de macronutrientes, patrones de ingesta alimentaria, y conducta alimentaria estuvieron asociados con la recuperación de peso en el período postoperatorio en pacientes de cirugía bariátrica. Material y Métodos: Estudio de casos y controles de pacientes sometidos a cirugía bariatrica. Los casos fueron definidos como aquellos pacientes que aumentaron ≥ 15% de peso en los dos años siguientes a la cirugía, y los controles fueron aquellos que no tuvieron ganancia de peso. Los participantes respondieron telefónicamente un recordatorio de ingesta. El historial de peso se obtuvo de la ficha clínica. Se utilizó una regresión logística para identificar factores nutricionales y de comportamiento relacionados significativamente con la recuperación de peso. Resultados: Participaron 54 casos (77% mujeres; 58% sometidos a manga gástrica) y 50 controles (70 % mujeres; 58% sometidos a baipás gástrico). La edad promedio de ellos fue 43 y 40 años, respectivamente. Se observó cuatro hábitos alimentarios y de estilo de vida asociados independientemente con mayores probabilidades de ganancia de peso postcirugía: comedor de dulces, picoteador, sedentarismo y mayor ingesta calórica diaria. Conclusiones: Una mayor ingesta energética diaria, el consumo de dulces, los picoteos y el sedentarismo se relacionan con una mayor probabilidad de ganancia de peso en el postoperatorio de cirugía bariátrica.