Patients' expectations and experiences of eating behaviour change after bariatric procedures

Patients' pre-surgical expectations and post-surgical experiences of eating-related behaviour change after bariatric surgery may vary by procedure and time since surgery. To investigate this, data were coded from 206 Australian adults ≥2 months post-Roux-en-Y gastric bypass (RYGB; 17%), adjustable gastric band (AGB; 23%) or vertical sleeve gastrectomy (VSG; 60%) who completed an online questionnaire including open-ended questions about pre-surgical eating-related expectations and post-surgical experiences. Participants were 94% female, and mean age was 45.9 (SD = 10.0). Average time since surgery varied (AGB: 69.6 months; RYGB: 22.8; and VSG: 17.8). The proportions reporting any one or more 'positive' (healthy, helpful or desired; RYGB 82%; AGB 76%; and VSG 84%) or any one or more 'negative' (unhealthy, unhelpful or unwanted; RYGB 46%; AGB 46%; and VSG 42%) post-surgical eating-related experience did not differ by procedure. Negative experiences were more often reported at ≥18 months than 2 to <18 months (P = 0.035). After both VSG and AGB, but not RYGB, reporting any one or more positive eating-related experience was related to better outcomes (VSG: in mental health; AGB: in weight loss, physical health, satisfaction) and negative experiences were linked to poorer outcomes (VSG: in mental health, satisfaction; AGB: in mental and physical health, satisfaction). Reporting any one or more positive experience was related to better mental health improvement at 2 to <18 months and greater satisfaction at 18+ months post-surgery. The findings highlight the necessity of long-term, multidisciplinary patient care and further investigation into impacts of eating-related experiences on outcomes, with attention to procedure-based and temporal effects.