Page 66 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 3
relationship with 24 months weight loss; patients had a higher decrease in external eating lost more weight. Contrary to previous research, in our study external eating was not related to more weight regain 12.
A surprising result was that the mean changes in self-reported physical activity (0.76) and eating styles (-0.32 to -0.61) were quite small. Other studies have also shown a small change in physical activity 39. For eating style, results are hard to compare since this was the first large study using the DEBQ. Other studies, using other ques- tionnaires, show variable results in changes of eating style 12,19,40. We did see a large range in the changes in physical activity and eating style. Another explanation for the small changes can be that in our treatment program patients are educated on physical activity and eating styles, patients might overestimate physical activity and underes- timate eating style before surgery and, with the education of the program, their own estimations change.
Although we included more than four thousand post-bariatric patients in this lon- gitudinal study, our data cannot be interpreted in a causal way. It could be that an increase in physical activity is causal to an increase in weight loss, but the association might as well be the other way around; a decrease in weight loss facilitating physical activity. Another limitation is the lost to follow-up of 39% and 53% of the patients at respectively 36 and 48-month follow up. Nonetheless, this is the first study assessing the effect of self-reported physical activity, emotional, external and restrained eating in such a large population with a follow-up until 48 months.
CONCLUSION
Based on our results we could argue that success after RYGB is not related to self-re- ported preoperative physical activity or eating behaviour. Therefore, the decision whether a patient is suitable for surgery should not be made on these self-reports of physical activity and eating style. In addition, professionals working in the bariatric field should be aware that these specific preoperative behaviours are not predictive of results.
Changes in self-reported physical activity, emotional eating and restrained eating and were related to increased weight loss. Future research should study whether changes in self-reported physical activity and/or eating style are causal to weight change after surgery. Lastly, efforts should be made in order to predict which patients will experi- ence weight regain in an earlier stage.
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