Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2012, Vol.28 (1), p.53-58
• Main Authors: Freire, Rachel Horta, M.Sc, Borges, Mariane Curado, M.Sc, Alvarez-Leite, Jacqueline Isaura, M.D., Ph.D, Correia, Maria Isabel Toulson Davisson, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Adult; Bariatric surgery; Biological and medical sciences; Body Mass Index; Brazil; Combined Modality Therapy; Counseling; Cross-Sectional Studies; Diet - adverse effects; Exercise; Feeding Behavior; Feeding. Feeding behavior; Female; Follow-Up Studies; Food habits; Food quality; Fundamental and applied biological sciences. Psychology; Gastric Bypass; Gastroenterology and Hepatology; Gastrointestinal surgery; Humans; Male; Medical Records; Middle Aged; Motor Activity; Nutritional Sciences - education; Obesity; Obesity, Morbid - diet therapy; Obesity, Morbid - prevention & control; Obesity, Morbid - surgery; Patient Education as Topic; Secondary Prevention; Sedentary Lifestyle; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; Weight Gain; Weight loss; Weight regain
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2011.01.011

Abstract Objective Assess the lifestyle habits, including food patterns, of patients who underwent Roux-en-Y gastric bypass (RYGB) and to identify predictive factors in weight loss and regain. Methods Obese patients (100) who underwent RYGB from 1998 to 2008 were included. Dietary habits were assessed by using 24 h dietary recall and the Food Frequency Questionnaire. Rates of weight regain and the percentage of excess weight loss (EWL) were calculated. Patients were also asked whether they attended nutritional follow-up visits after the operation and about the type and regularity of physical activities. Results The mean age was 45.1 ± 9.9 y, and the majority of the patients were women (84%). Mean EWL was 59.1 ± 20.3%. Weight regain was seen in 56% of the patients with 29% of the patients having regained over 10.1% of the minimum weight reached after RYGB. Weight regain increased significantly with time after surgery (up to 2 y: 14.7%; from 2 to 5 y: 69.7%; over 5 y: 84.8%). Poor diet quality characterized by excessive intake of calories, snacks, sweets, and fatty foods was statistically higher among those who regained weight. Sedentary lifestyle and lack of nutritional counseling follow-up were also significantly associated with regaining weight. Conclusion Despite satisfactory results of EWL, the patients did not properly maintain the lost weight, mainly after 5 y postsurgery. Major factors that influenced this weight gain were poor diet quality, sedentary lifestyle, and lack of nutritional counseling follow-up.