Decreased emotional eating behavior is associated with greater excess weight loss five years after gastric banding

Eating behaviors and dietary intake 2 to 4 years following sleeve gastrectomy: Are there any associations?

OBJECTIVES

A lack of research exists on associations between eating behaviors and dietary intake among patients undergoing bariatric surgery. This study aimed to ascertain the association between eating behaviors and dietary quantity and quality at mid-term postsleeve gastrectomy (SG).

METHODS

This cross-sectional study included 146 adults within 2 to 4 years post-SG. Dietary intake and eating behaviors were assessed using a food frequency questionnaire and the Dutch Eating Behavior Questionnaire, respectively. Energy and the proportion of macronutrients were determined. Carbohydrate quality index (CQI), fat quality index (FQI), healthy plate protein quality index (HPPQI), macronutrient quality index (MQI), and Healthy Eating Index (HEI)-2015 were computed to evaluate diet quality. Participants were categorized into high and low groups based on median scores for each eating behavior scale. Least-squared (geometric) means and 95% confidence intervals were determined for each group using the analysis of covariance, adjusted for age and sex.

RESULTS

The mean time since surgery for participants was 30.8 ± 6.5 months, and 77.4% were female. Participants with high emotional eating had higher energy and HPPQI. Individuals with high external eating had higher energy and percentages of fat and lower FQI and HEI scores. Individuals with high restrained eating scores demonstrated lower energy intake but a higher percentage of protein intake and higher CQI, FQI, MQI, and HEI scores.

CONCLUSIONS

External eating showed the most unfavorable associations, while restrained eating showed the most favorable associations with quantity and quality of diet 2 to 4 years after SG. Emotional eating was minimally related to dietary characteristics.

Identification of several eating habits that mediate the association between eating behaviors and the risk of obesity

Objective

Eating behaviors play important roles in the development of obesity. A better knowledge of the psychological aspects of eating behaviors in individuals with and without obesity and their consequences on daily eating and lifestyle habits would be informative. The Three-Factor Eating Questionnaire (TFEQ)-R21 assesses the psychometrics of eating behavior. The objectives of the study were to establish which eating habits were or were not associated with TFEQ eating behaviors, and to quantify the extent to which those eating habits mediated the association between TFEQ eating behaviors and obesity risk.

Methods

Data were obtained from the Gene and Environment Case-Control Obesity Study from northern France. It included 2237 individuals with obesity and 403 individuals without obesity. Eating behaviors were assessed according to the TFEQ-R21. Two activity levels (physical activity and television watching) and six eating habits (e.g., plate size, having one serving or at least two servings of the main meal, …) were evaluated. Regression and mediation analyses were performed.

Results

Higher cognitive restraint, higher uncontrolled eating (UE) and higher emotional eating (EE) were associated with a higher risk of obesity, independently of each other and of age, sex, socio-economic status and physical activity. Cognitive restraint was negatively associated with having at least two servings, while UE and EE were associated with several obesogenic habits such as eating in front of the television or eating at night. Each of these obesogenic habits mediated between 3% and 20% of the association between UE or EE and obesity.

Conclusions

Psychological eating behaviors were associated with several lifestyle and eating habits in both individuals with and without obesity. Moreover, some eating habits partially mediated (between 3% and 20%) the association between TFEQ eating behaviors and obesity risk. For clinicians, this study shows that simple, easy-to-ask questions on specific daily eating habits can provide essential information to better understand and manage patients with obesity.

Eating in case of emotion dys-regulation, depression and anxiety: Different pathways to emotional eating in moderate and severe obesity

Emotion dys-regulation is thought to be involved in the development and maintenance of emotional eating (EE), notably through its links with anxious and depressive symptoms. AIM: The aims of the study were to: (a) examine the mediating effect of depressive and anxious symptoms on the relationship between emotion dys-regulation and EE in obesity and (b) compare those links with various degrees of obesity severity. One hundred and twenty patients with obesity, including 60 with "n" (MO) (30 ≤ BMI < 40) and 60 with "severe obesity" (SO) (BMI > 40), completed self-report measures of emotion dys-regulation, depression, anxiety and EE. Partial least square structural equation modelling and multi-group analyses were performed. Emotion dys-regulation was found to be significantly associated with EE only when the severity of obesity was taken into account. In addition, although the MO and SO groups reported similar levels of emotional and eating disorders, significant differences were found between the groups in pathways leading to EE. In MO, emotion dys-regulation was only associated with more EE through more anxiety. In SO, emotion dys-regulation was both directly and indirectly associated with more EE, but only through more depression in the latter. Emotion dys-regulation, anxiety and depression do not have the same impact on EE depending on the severity of obesity. Psychotherapeutic interventions should aim at reducing emotion dys-regulation in obesity from MO onwards, but the focus should be on the management of anxiety-related affects in MO and depression-related affects in SO.