Impact of bariatric surgery on food addiction in obese patients with type 2 diabetes mellitus

Abstract

Objective To observe the effects of bariatric surgery and the status of food addiction on obese patients with type 2 diabetes mellitus (T2DM) . Methods A total of 76 obese T2DM patients who had undergone bariatric surgery (operation group, n=38) or traditional medical treatment (control group, n=38) were enrolled from January 2010 to November 2015. The food addiction status was investigated by five core questions of Yale Food Addiction Scale (YFAS) (Q1: eating much more than planned when eating certain foods; Q2: spending time in dealing with negative feelings from consumed certain foods so often or in such large quantities; Q3: consuming the same types or the same amount of food even though having emotional and/or physical problems; Q4: appearance of withdrawal symptoms when cut down or stopped eating certain foods (for example: developing physical symptoms, feeling agitated, or feeling anxious); Q5: behavior with respect to food and eating causes significant distress). Blood glucose, obesity and the food addiction status were investigated. The data of YFAS were analyzed by McNemar test within groups while inter-group comparisons by rank sum test. Results Compared with control group, fasting plasma glucose [(5.6±1.0) vs (7.7±2.0)mmol/L], glycated hemoglobin A1c [(6.1±0.6)% vs (7.3±1.2)%], and body mass index [ (28±4) vs (34±4) kg/m2] were significantly improved in operation group (z=2.38-6.70, all P<0.05). After surgery, all five questions (Q1-Q5) for food addiction were significantly improved compared with preoperation (s=13.00-28.00, all P<0.05). Compared with control group, the three questions (Q1, Q2, Q3) were greatly improved in operation group (z=2.85-3.29, all P<0.05). The average difference between the operation group and the control group was Q1: 0.71 vs 0.34, Q2: 0.73 vs 0.32, Q3: 0.65 vs 0.29, respectively. Conclusion Compared with traditional medical treatment, bariatric surgery may significantly improve the food addiction of obese patients with T2DM in addition to lower blood sugar, body weight. Key words: Diabetes mellitus, type 2; Obesity; Bariatric surgery; Food addiction