Psychological Eating Behaviors as Predictors of 15-year Weight Changes After Surgical Treatment for Severe Obesity

Abstract

Background: There is a need for better understanding on the factors predicting long-term weight outcomes after bariatric surgery. This study examined whether psychological eating behaviors (cognitive restraint, disinhibition, hunger) were prospectively related to short- and long-term weight changes after surgical treatment for severe obesity. Methods: Participants were bariatric surgery patients (n=2010) from the Swedish Obese Subjects study, which is an ongoing, matched (non-randomized), prospective intervention trial. Physical measurements (weight, height) and questionnaires (Three-Factor Eating Questionnaire) were completed prior to surgery and 0.5, 1, 2, 3, 4, 6, 8, 10 and 15 years after the treatment. Findings: Pre-treatment eating behaviors were unrelated to subsequent weight changes, while lower 6-month and 1-year levels of disinhibition and hunger were associated with greater 2-,10- and 15-y weight loss (B=0.19–0.36 in men, B=0.09–0.28 in women, all p<0.05). Discussion: Problems in the regulation of eating shortly after bariatric surgery predicted poorer long-term weight outcomes, making post-operative overeating tendencies an important indicator of targeted interventions.