RELATIONSHIP BETWEEN FOOD AND EATING BEHAVIORAL PROBLEMS AND CLINICAL OUTCOMES IN ADULTS WHO ELECTED THE LAPAROSCOPIC SLEEVE GASTRECTOMY

Background:
Food and eating behavioral problems (FEBPs) including poor cooking skills and binge, grazing, and emotional eating are strongly linked to weight gain. Better understanding of FEBPs experienced by laparoscopic sleeve gastrectomy
(LSG) patients and their association with postoperative outcomes in the real-world setting is required to guide multidisciplinary team support.

Objectives:
Explore the association between the number and type of FEBPs routinely identified by healthcare professionals with postoperative weight loss, micronutrient deficiencies, and events in adults who elected an LSG.

Methods:
An observational cohort study recruited LSG patients from one site in Australia. FEBPs documented by dietitians, nurses, or psychologists were observed from medical records. FEBPs were tested for association with outcomes at
6- and 12-months using SPSS. Outcomes were excess weight loss (EWL), micronutrient deficiencies, and events (defined as symptoms, side-effects, or adverse events triggering clinical support).

Results:
215 patients were recruited (median BMI:40.9 [IQR: 37.0-45.0] kg/m2
; female: 77.7%; mean age 41.4 [SD:9.5] years). Twenty types of FEBPs were identified with mean 6.4 (SD:2.1) FEBPs per patient. The most common FEBPs were large portion sizes (91.6%), emotional eating (62.8%), irregular meal patterns (61.4%), and night eating (49.8%). EWL was median 60.4 (IQR: 48.3-76.1)% and 81.1 (IQR: 65.8-101.2)% at 6- and 12-months, respectively. 24.6%
and 63.6% of patients had one or more micronutrient deficiencies at 6- and 12-months, respectively. There was a median of 4.0 (IQR:2.0–5.0) events per patient which were mostly mild gastrointestinal symptoms (89.3%) between
day-of-surgery and 6-months post-surgery (86.1%), e.g., constipation, nausea, reflux. FEBPs were not associated with weight loss nor micronutrient deficiency. Night eating was associated with higher frequency of gastrointestinal
events at 6-months (p<0.001), surgical or medical events at 6-months (p=0.002), and nutrition-related events at 6- and 12-months (p=0.005 and p=0.008, respectively).

Conclusion:
Australian adults who elected an LSG experienced a wide variety and high frequency of FEBPs. Night eating was associated with gastrointestinal, medical, and nutrition-related events. Multidisciplinary teams supporting LSG patients
should focus on behavior change to address FEBPs and ensure to address night eating behavior.