Comparison of food tolerance among bariatric surgery procedures: a systematic review

Bariatric surgeries are related to reduced food tolerance (FT), which may impact on nutritional status and weight loss treatment. The present study was conducted to compare the effects of gastric banding (GB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) on FT. A literature search was performed using Scopus, PubMed, Web of Science, and Google Scholar to find relevant studies published up to August 2023. The primary outcome was the postoperative overall FT score assessed by the Quality of Alimentation questionnaire. Overall, 27 studies containing 4366 adults were included in the review: 15 cohort studies, 5 interventional studies, and 7 cross-sectional studies. The quality of articles ranged between low and high. Thirteen studies evaluated the effect of SG on FT; however, 4 studies reported FT following RYGB. The postsurgery FT of GB patients was examined in 1 study. The mixture of bariatric techniques was evaluated in 9 papers. Selected studies assessed FT from 1 month to 5 years following obesity surgery. Taken together, GB patients showed the lowest level of FT. Although SG and RYGB patients had no difference in FT, RYGB ones had better tolerance to protein-rich foods such as red meat, white meat, and fish. Both SG and RYGB individuals tolerated vegetables and fish more than other food groups and could least tolerate red meat and grains. After the first postoperative year, a good level of FT was found among SG and RYGB patients.