Impact of gastric banding on eating behavior and weight

Laparoscopic adjustable gastric banding (LAGB) is now the most frequently performed gastric restriction procedure. While short- and long-term outcome have been described extensively, the relationship between eating behavior and weight reduction is still unclear.

The present study examined the eating behavior of 66 selected morbidly obese subjects before and after LAGB by means of the Eating Inventory (EI), the Binge Scale Questionnaire (BSQ) and additional items. Assessments were conducted 6 months before surgery and at 3, 9, and 12 months after surgery.

Significant reductions of weight and BMI were observed until 9 months after surgery, with a loss of 34.5% of excess weight. Later, a slight weight regain was noted. At baseline, Cognitive Restraint (CR), Hunger (H) and Flexible Control (FC) were within the norm, whereas Disinhibition (D) and Rigid Control (RC) were significantly elevated. None of the scales were related to BMI. At follow-up, significant changes were observed between presurgery and 3 months follow-up (T2), with increased CR, FC, and RC, and decreased D, H, and Binge Eating. These changes mostly remained stable. The largest changes were observed 3 months post-surgery in Flexible Control (FC), followed by D, CR, H, and RC. At follow-up, again no correlation was found between eating behavior and the total difference of BMI.

LAGB results in significant reductions of weight, disinhibition and hunger during the first 9 months postoperatively. The change in eating behavior after surgery is independent of BMI and characterized mostly by elevated flexible control. Results indicate also changes of other behaviors that contribute to weight loss but are difficult to control.