Patients’ pre and post-bariatric surgery experience of dieting behaviours : Implications for early intervention

Journal article


Klapsas, Margaret and Hindle, Annemarie. (2023). Patients’ pre and post-bariatric surgery experience of dieting behaviours : Implications for early intervention. Obesity Surgery. 33(9), pp. 2702-2710. https://doi.org/10.1007/s11695-023-06689-x
AuthorsKlapsas, Margaret and Hindle, Annemarie
Abstract

Purpose
Bariatric surgery works, in part, by surgically changing signals of hunger and satiety to achieve weight loss. Not all patients experience optimal outcomes. One potential explanation is that post-surgery dieting may subvert the ability to identify physiological cues of hunger and fullness. Dieting behaviours (e.g. restriction/cognitive restraint) are correlated with disordered eating, and disordered eating implicated in poor outcomes. This study examines the experience of dieting after bariatric surgery.

Method
Seventeen adult participants who had undertaken bariatric surgery and residing in Australia participated in semi-structured interviews. Surgeries occurred in 2021 (n = 8), 2020 (n = 4), 2019 (n = 2), and one participant each had surgery in 2014, 2009, and 2004. Thematic analysis elicited themes related to post-operative dieting.

Results
All participants reported chronic pre-surgery dieting. Lifestyle change was the overarching post-surgical theme comprising (i) flexibility (e.g. allowing food, intuitive eating), and (ii) control, comprising surgery control (e.g. set portions, surgery instilled control) and dieting control (e.g. discipline, restriction/restraint). Descriptions of lifestyle change often mirrored pre-surgery descriptions of dieting.

Conclusion
Post-surgery lifestyle change appears to encompass a tension between flexible/adaptive approaches to eating and the need to maintain control. Control may emerge as practices that mirror pre-surgery dieting with the potential to interfere with adaptive eating behaviours or promote disordered eating. Dieting behaviours may be a precursor to the development of disordered eating. Health care practitioners should regularly assess dieting behaviour post-surgery to enable early intervention where warranted. Future research should consider how post-surgery re-emerging dieting may be identified and measured to aid in intervention.

Keywordsbariatric surgery; dieting; post-surgery; disordered eating; restraint
Year2023
JournalObesity Surgery
Journal citation33 (9), pp. 2702-2710
PublisherSpringer
ISSN0960-8923
Digital Object Identifier (DOI)https://doi.org/10.1007/s11695-023-06689-x
PubMed ID37468701
Scopus EID2-s2.0-85165191991
Page range2702-2710
FunderAustralian Catholic University (ACU)
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online19 Jul 2023
Publication process dates
Accepted16 Jun 2023
Deposited04 Apr 2025
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