Food Addiction and Dietary Intake in Morbidly Obese Females Before and After Vertical Sleeve Gastrectomy

Abstract

Bariatric surgery can be a successful treatment option for morbid obesity when dietary, exercise, and pharmacotherapy interventions fail. However, food addiction (FA) is a condition that can hinder the perceived value of food reward resulting in overconsumption of highly palatable food. The presence of FA not only contributes to the development of obesity but may also lessen weight loss success that occurs from bariatric surgery. The aim of this study was to examine dietary intake and identify the prevalence of FA in obese women before and three months following vertical sleeve gastrectomy (VSG). Obese females [body mass index (BMI) ≥ 35] undergoing VSG were recruited from a bariatric surgical practice at Houston Methodist Hospital in Houston, Texas. The Yale Food Addiction Scale (YFAS) questionnaire and 24‐hour dietary recall were administered by a Registered Dietitian Nutritionist during the pre‐surgery and three‐month post‐surgery clinic appointments. FA was identified based on results from the YFAS questionnaire, which assessed seven diagnostic symptoms for FA and clinical impairment. Mean energy and nutrient (carbohydrate, fat, protein, fiber, and added sugar) intake were analyzed by the Nutrition Data System for Research program. Fifteen morbidly obese females (mean age of 46.5 ± 3.1 years) were enrolled in the study and 60% (n = 9) reported having FA. Prior to VSG, the mean body weight of females with FA and without FA was 134.4 ± 13.5 kg versus 135.4 ± 10.2 kg, respectively. Likewise, the females with FA had a mean BMI of 50.9 ± 3.9 kg/m2 compared to 49.5 ± 2.7 kg/m2 in the group without FA. Mean body weight, BMI, energy or nutrient intake did not differ between groups before or three months following VSG. However, the females with FA resolution post‐VSG (n = 7; 53.3%) had significant reductions in weight (−13.1%, P = 0.010), BMI (−10.9%; P = 0.037), energy (−43.4%; P = 0.011), fat (−51.9%; P = 0.013), carbohydrate (−42.7%; P = 0.014), and fiber (−45.9%; P= 0.022). The females without FA before and after VSG (n = 6; 40%) had a −7.4% reduction in weight (P = 0.049) and −11.5% reduction in BMI (P = 0.026) without significant changes in nutrient intake over time. Three months post‐VSG the prevalence of FA decreased by −72.1% with only 16.7% (n = 2) reporting FA. In conclusion, body weight and BMI are similar in morbidly obese females with and without FA. VSG resulted in significant reductions in energy, fat, carbohydrate, and fiber intake that coincided with the resolution of FA post‐surgery. VSG is an effective surgical procedure that decreases nutrient intake and assists in the resolution of FA in morbidly obese females.Support or Funding InformationFaculty Research Enhancement Program from the Office of Research and Sponsored Programs at Texas Woman's University