Association Between Changes in Control of Eating and Sleeve Gastrectomy Outcomes at One Year

• Published in: Obesity (Silver Spring, Md.) Vol. 30; pp. 162 - 163
• Main Authors: Lytvyak, Ellina, Zarrinpar, Amir, Ore, Cecilia Dalle, Lee, Euyhyun, Yazdani-Boset, Keila, Horgan, Santiago, Grunvald, Eduardo
• Format: Journal Article
• Language: English
• Published: Silver Spring Blackwell Publishing Ltd 01.11.2022
• Subjects: Gastrointestinal surgery
• ISSN: 1930-7381; 1930-739X

Background: Weight loss response to sleeve gastrectomy is variable; hence, predicting the effectiveness of surgery is challenging and elusive. Our study aimed to assess and quantify the association between changes in control of eating and weight loss outcomes one year after surgery. Methods: A prospective longitudinal cohort study using the Control of Eating Questionnaire (CoEQ), a visual analogue scale, was designed as a series before and at 3, 6, and 12 months post-surgery. Primary outcomes were changes in selected control of eating attributes, and percent of total weight loss (%TWL) 12 months post-surgery, with % TWL >25% set as a successful weight loss target. Sex, smoking and weight status were assessed for covariance. Differences in CoEQ scores and weight status were analyzed using a two-sided t-test, Mann-Whitney and Wilcoxon signed-rank tests. Univariate and multivariate logistic regression was used to determine the association of control of eating attributes and potential contributing factors with weight loss outcomes. Results: Forty-one patients (80.5% females, 51.2% Hispanic, mean age 41.7±10.6, median baseline BMI 43.6 kg/m2 [range 35.2-66.3]) who completed CoEQ at all four timepoints were included. Patients with %TWL ≥25% did not differ substantially from those with %TWL <25% by sex, age, smoking, weight, baseline BMI, and CoEQ attributes, except for "Desire for sweets" (44 [0-90] vs. 75 [9-100], p=0.026). At 3 months, "Difficulty to control eating" score was significantly different between %TWL ≥25% and %TWL <25% groups (7 [0-50] vs. 17 [5-63], p=0.042). Moreover, "Difficulty to control eating" score ≤7 mm at 3 months was strongly independently associated with %TWL ≥25% (OR 4.50; p=0.030), and after adjusting for sex, smoking and baseline BMI, the association remained strong (OR 4.73; p=0.031). Conclusions: "Difficulty to control eating" score measured at 3 months post sleeve gastrectomy serves as a strong early predictor of achieving a successful total weight loss target of ≥25% at one year. The results of our study provide strong evidence and open avenues for using an easy-to-administer, validated tool for predicting the effectiveness of sleeve gastrectomy. If validated with larger studies, targeting poor responders to bariatric surgery may help improve weight loss with earlier interventions.