Background: Bariatric surgery is highly successful for the long-term management of obesity. Patients’ behaviours may influence the degree of weight loss attained. This study aimed to assess whether preoperative eating behaviours were predictive of weight loss following bariatric surgery using the three-factor eating questionnaire1 (TFEQ) which evaluates the eating behaviours of cognitive restraint, disinhibition and hunger.
Methods: A retrospective cohort of patients who underwent bariatric surgery and completed the TFEQ preoperatively was identified. Body weight was collected before and at 6, 12, 18 and 24 months following bariatric surgery. TFEQ scores were categorised as low, medium and high for each factor. A repeated measures ANOVA was conducted to assess whether percentage total body weight loss (%TBWL) over time differed between the categories for each factor. A secondary analysis assessed if the mean continuous TFEQ scores differed by higher (≥20% TBWL) or lower (<20% %TBWL) weight loss (LWL) at 12 months.
Results: Included patients (n=159) had mean age 49.9 ± 10.9 years, mean BMI 48.8 ± 9.2 and 73% (n=116) were female. Bariatric surgeries included laparoscopic sleeve gastrectomy (n=126), omega-loop gastric bypass (n=19) and other (n=14). Higher weight loss (HWL) (≥20% TBWL) was achieved by 118 participants at 12 months with 41 participants achieving LWL. There was a significant difference (p = 0.016) in %TBWL across the categories of disinhibition, with high disinhibition patients attaining greater weight loss compared to low disinhibition (p = 0.026). Mean disinhibition scores were higher in the HWL (9.8 ± 3.8) compared to the LWL (8.4 ± 3.4) group (p = 0.036). Restraint and hunger components of the TFEQ were not predictive of %TBWL.
Conclusion: Contrary to previous literature, disinhibition significantly predicted postoperative weight loss, as patients with high baseline disinhibition attained greater weight loss. Further research is required to understand this finding.