Abstract
Even though bariatric surgeries (BS) are on the rise in Lebanon and the Middle East, the changes in diet quality, binge eating, and food cravings in this region are poorly studied peri-operatively. This cross-sectional study aimed to assess binge eating behaviors, food craving and the Healthy Eating Index (HEI) in Lebanese patients who underwent BS in a duration that exceeds 6 months. Evaluation included a dietary assessment of usual diet preoperatively and postoperatively. It included the collection of information on sociodemographic, anthropometric and surgical variables, as well as the administration of dietary recalls and questionnaires to calculate the HEI score, the Binge Eating Scale (BES) and the Food Craving Inventory (FCI). Participants (n = 60) were mostly females (85%) who had undergone sleeve gastrectomy (90%), with a mean duration since BS of 2.4 ± 1.8 years. Despite improvements in their HEI scores, 97% of the participants remained in the worst category. The frequency of participants in the severe BES category dropped markedly postoperatively from 78% to 5% (p < 0.01). Food craving followed a similar trend, with scores dropping from 50 ± 36 pre-surgery to 30 ± 25 post surgery (p < 0.01). Weight regain, prevalent among 40% of participants, was predicted by BES. Despite the improvement in BES and FCI, HEI improvement remained shy. Future interventions should validate findings in other countries and assess means for optimizing HEI scores among BS patients in the Middle East region.
Highlights
Obesity has been weighing more heavily on individuals, communities, and health care systems over the last decades [1]
A total of 60 subjects participated in the study, most of whom were females (85%) who had undergone sleeve gastrectomy (90%) (Table 1)
The results revealed that weight regain was not significantly associated with changes in the daily caloric intake and diet quality, as assessed with the Healthy Eating Index (HEI) components
Summary
Obesity has been weighing more heavily on individuals, communities, and health care systems over the last decades [1]. Bariatric surgery (BS), recommended when noninvasive lifestyle interventions fail, is the most efficient treatment approach for weight management, and has been associated with a reduction in cardiovascular diseases, cancer incidence and mortality, as well as an improvement in quality of life and self-esteem [2,3,4,5,6]. It has been estimated that only 40% of BS patients maintain 30% of weight loss 12 years after the surgery [7,8,9]. Poor adherence to a Mediterranean diet and having a low Healthy Eating Index (HEI) have been linked to weight regain post operatively [10,11]. Other culprits of weight regain include eating disorders, and limited follow up with the multidisciplinary team [9,11,12,13,14,15,16]
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