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Eating Behaviors Post-Bariatric Surgery: A Qualitative Study of Grazing

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Abstract

Background

Eating behaviors after bariatric surgery play an important role in postoperative outcomes. The purpose of this study was to explore eating behaviors among post-bariatric surgery patients, including developing a better understanding of the term “grazing”, as interpreted by patients.

Methods

This study was conducted at a research institute with a community-based sample. Structured focus groups using the nominal group technique were conducted with five groups of post-bariatric patients (n = 29). All patients were over 18 years old and reported having bariatric surgery at least 1 year prior to participation. Participants were asked to produce responses to the question: “What does grazing mean to you?” Then, they were instructed to rank their responses to the questions: “What is grazing?” and “How does grazing affect you?”

Results

The mean age of the sample was 47, mean body mass index was 29.0 kg/m2, and the majority of the participants were women (93 %). The group members generated a total of 105 responses, which were categorized into 17 themes. Common responses included eating frequently all through the day, out of control eating, and eating due to boredom, not hunger. Results suggest that grazing has a number of unique interpretations, including mindful and mindless behaviors.

Conclusions

Post-bariatric surgery patients seem to view grazing as a healthy eating behavior characterized by mindful food choices that are consumed in small amounts frequently throughout the day. However, grazing may also be viewed as an unhealthy eating pattern when it is perceived as unplanned, mindless, continuous food consumption.

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References

  1. Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity. 2008;16:615–22.

    Article  PubMed  Google Scholar 

  2. Sarwer D, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence and weight loss following gastric bypass surgery. Surg Obes Relat Dis. 2008;4:640–6.

    Article  PubMed  Google Scholar 

  3. Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2011;28(1):53–8.

    Article  PubMed  Google Scholar 

  4. Saunders R. “Grazing”: a high-risk behavior. Obes Surg. 2004;14:98–102.

    Article  PubMed  Google Scholar 

  5. Poole NA, Atar AA, Kuhanendran D. Compliance with surgical after-care following bariatric surgery for morbid obesity: a retrospective study. Obes Surg. 2005;15:261–5.

    Article  PubMed  Google Scholar 

  6. Saunders R. Binge eating in gastric bypass patients before surgery. Obes Surg. 1999;9:72–6.

    Article  PubMed  CAS  Google Scholar 

  7. Busetto L, Segato G, DeMarchi F, et al. Outcome predictors in morbidly obese recipients of an adjustable gastric band. Obes Surg. 2002;12:83–92.

    Article  PubMed  Google Scholar 

  8. Hsu LKG, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338–46.

    PubMed  CAS  Google Scholar 

  9. Delbecq AL, VandeVen AH, Gustafson DH. Group techniques for program planning: a guide to nominal group and Delphi processes. Glenview: Scott Foresman; 1975.

    Google Scholar 

  10. White MA, Kalarchian MA, Masheb RM, et al. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry. 2010;71(2):175–84.

    Article  PubMed  Google Scholar 

  11. de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6:79–87.

    Article  PubMed  Google Scholar 

  12. Kalarchian MA, Marcus MD, Wilson GT, et al. Binge eating among gastric bypass patients at long-term follow-up. Obes Surg. 2002;12:270–5.

    Article  PubMed  Google Scholar 

  13. Mitchell JE, Lancaster KL, Burgard MA, et al. Long-term follow-up of patients’ status after gastric bypass. Obes Surg. 2001;11:464–8.

    Article  PubMed  CAS  Google Scholar 

  14. Niego SH, Kofman MD, Weiss JJ, et al. Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Disord. 2007;40:349–59.

    Article  PubMed  Google Scholar 

  15. Mitchell JE, Steffen K. The interface between eating disorders and bariatric surgery. Eat Disord Rev. 2009;20(1):1.

    Google Scholar 

  16. Kruseman M, Leimgruber A, Zumback F, et al. Dietary, weight and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010;110:527–34.

    Article  PubMed  Google Scholar 

  17. Thomas JG, Bond DS, Sarwer DB, et al. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis. 2011;7:548–57.

    Article  PubMed  Google Scholar 

  18. Ziegler O, Sirveaux MA, Brunaud L, et al. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35:544–57.

    Article  PubMed  CAS  Google Scholar 

  19. Elkins G, Whitfield P, Marcus J, et al. Noncompliance with behavioral recommendations following bariatric surgery. Obes Surg. 2005;15:546–51.

    Article  PubMed  Google Scholar 

  20. Rusch MD, Andris D. Maladaptive eating patterns after weight-loss surgery. Nutr Clin Pract. 2007;22:41–9.

    Article  PubMed  Google Scholar 

  21. Thomas JG, Bond DS, Ryder BA, et al. Ecological momentary assessment of recommended postoperative eating and activity behaviors. Surg Obes Relat Dis. 2011;7:206–12.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study received funding from the Neuropsychiatric Research Institute, Fargo, ND, USA.

Conflict of interest

All contributing authors declare that they have no conflicts of interest.

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Correspondence to Christie Zunker.

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Zunker, C., Karr, T., Saunders, R. et al. Eating Behaviors Post-Bariatric Surgery: A Qualitative Study of Grazing. OBES SURG 22, 1225–1231 (2012). https://doi.org/10.1007/s11695-012-0647-7

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  • DOI: https://doi.org/10.1007/s11695-012-0647-7

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