Food cravings after bariatric surgery: comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

BackgroundResearch suggests that food choices, preferences, and tastes change after bariatric surgery, but evidence regarding changes in food cravings is mixed.ObjectivesThe primary aim of this cohort study was to compare food cravings during the first year following bariatric surgery in patients who had undergone sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB).SettingIntegrated multispecialty health system, United States.MethodsPatients aged >= 18 years seen between May 2017 and July 2019, provided informed consent, completed the Food Craving Inventory (FCI), and had >= 1 year of follow-up after undergoing primary SG or RYGB were included in the study. Secondary data captured included psychological and behavioral measures. Preoperative and postoperative (3, 6, 9, and 12 months) FCI scores of patients who underwent SG and RYGB were compared.ResultsSome attrition occurred postoperatively (N = 187 at baseline, 141 at 3 months, 108 at 6 months, 89 at 9 months, and 84 at 12 months). No significant relationship between pre- or postoperative food cravings and surgery type was found except on the carbohydrate subscale. Patients with higher preoperative food addiction symptoms were not more likely to experience an earlier reoccurrence of food cravings during the first 12 months after surgery. Likewise, patients with higher levels of preoperative depression and anxiety were not more likely to have early reoccurrence of food cravings during the first 12 months after surgery; however, those with higher PHQ9 scores at baseline had uniformly higher food craving scores at all timepoints (pre-surgery, 3 m, 6 m, 9 m, and 12 m).ConclusionsResults suggest that food cravings in the year after bariatric surgery are equivalent by surgery type and do not appear to be related to preoperative psychological factors or eating behaviors.Level of evidenceLevel III: Evidence obtained from well-designed cohort. Food cravings are significantly reduced after bariatric surgery, although they generally do not differ by surgery type. (With the exception of carb cravings, specifically, which were higher for those undergoing RYGB than SG).Patients with higher levels of preoperative depression and anxiety were not more likely to have early reoccurrence of food cravings during the first 12 months after surgery; however, those with higher PHQ9 scores at baseline had uniformly higher food craving scores at all timepoints (pre-surgery, 3 m, 6 m, 9 m, and 12 m).Patients with higher preoperative food addiction symptoms were not more likely to experience an earlier reoccurrence of food cravings during the first 12 months after surgery.