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JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

Dietary, Weight and Psychological Changes Among Patients with Obesity, 8 Years After Gastric By-Pass. Maaike Kruseman, RD, MPH; University of Applied Sciences Western Switzerland (HES-SO) Anik Leimgruber, RD; HES-SO Flavia Zumbach, RD; HES-SO Alain Golay, MD; University Hospitals of Geneva.

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JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

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  1. Dietary, Weight and Psychological Changes Among Patients with Obesity, 8 Years After Gastric By-Pass Maaike Kruseman, RD, MPH; University of Applied Sciences Western Switzerland (HES-SO) Anik Leimgruber, RD; HES-SO Flavia Zumbach, RD; HES-SO Alain Golay, MD; University Hospitals of Geneva JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

  2. Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Study overview Objective • The goal of this study was to document dietary and anthropometric changes more than five years after gastric bypass surgery. • Secondary goal was to document participants’ eating behavior, psychological state and quality of life. JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

  3. Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Baseline data Participants • Cohort of 80 women who underwent Roux-en-Y gastric bypass between 1997 and 2002 were followed up in a Swiss University Hospital for an average of 8 years JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

  4. Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Outcomes BMI & Psychosocial measures • Primary Outcome • Successful weight loss defined as Excess Weight Lossa (EWL) >50% • Other outcomes • Body composition (measured with bioelectrical impedance analysis) • Diet intake (assessed via four day food diary) • Eating disorders, psychological factors and quality of life (assessed via questionnaires) • Perceptions of difficulties and benefits (assessed using semi-structured interviewing) a. EWL was computed as = ((weight at baseline - weight at follow-up visit) / excess weight at baseline) * 100, where “excess weight” was the difference between weight at baseline and weight corresponding to a BMI of 25 kg/m2 JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

  5. Correlation matrix Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Average anthropometric changes: (n= 80 female patients) Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April). JOURNAL OFTHE AMERICAN DIETETICASSOCIATION

  6. Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Figure Successful or Unsuccessful? The meaning of “Excess weight loss” • Successful weight loss is usually expressed as ≥50% of excess weight loss (EWL). • EWL = (weight at baseline – weight at follow-up visit) / • excess weight at baseline * 100 • Excess weight at baseline is the difference between weight at baseline and weight corresponding to a BMI >25 • 47 patients (59%) were successful according to EWL criteria • However, 24 among them (51%) had regained at least 5 kg during one year follow-up, and some expressed guilt and shame. JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

  7. Figure Dietary, weight and psychological changes among patients with obesity, 8 years after gastric by-pass. Conclusion • Weight regain should be addressed early by the dietitian: it is not • incompatible with success, but can trigger patients’ negative • feelings and could increase risk of unhealthy dietary behaviors. JOURNAL OFTHE AMERICAN DIETETICASSOCIATION Kruseman et al.J Am Diet Assoc. 2010; Volume 110 (April).

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