Postoperative grazing as a risk factor for negative outcomes after bariatric surgery

• After bariatric surgery, de novo eating patterns can develop, such as grazing
• One aim of the study is to analyze the frequency of grazing among patients who undergo bariatric surgery.
• We also wanted to assess the influence of such eating pattern in different outcomes.
• Abnormal eating patterns should be monitored after surgery to prevent weight regain or unsuccessful results.

Introduction/purposeAfter bariatric surgery, de novo eating patterns can develop, such as grazing. Although grazing has been associated with poorer weight loss, it has received minimal attention. We aimed to assess the influence of grazing in clinical, biochemical and psychological outcomes in a bariatric surgery sample.Materials and methodsSixty patients (78.3%♀, age 46.35 ± 9.89, months since BS 46.28 ± 18.1) who underwent BS were evaluated cross-sectionally. Clinical, biochemical and psychological parameters were recorded. A pattern of grazing was assessed in this group of patients through interview.Results41.7% met criteria for grazing. Mean time since BS was greater in the group with grazing (57.64 ± 23.7 months vs 38.8 ± 26.44 months; p = 0.008). Although there were no differences in initial and current BMI, the percentage of patients with weight regain was greater among patients with grazing (72% vs 11.7%; p < 0.0001) and the percentage of excess weight loss was lower (28.15 ± 6.96% vs 33.35 ± 11.9%; p = 0.05). There were more difficulties in following the standardized visits according to our hospital's protocol (17.6% vs 56%; p = 0.009). No significant differences were found when assessing presurgical psychiatric comorbidity among patients with a grazing pattern and individuals without this condition (68% vs 55.9%; p = 0.423). When assessing quality of life only mental health was lower among patients with grazing (49.6 ± 22.7 vs 64.2 ± 23.3; p = 0.02).ConclusionDevelopment of grazing is frequent after BS, especially when weight loss has reached a plateau. Due to its potential association with weight regain, systematic screening of grazing after BS is warranted.