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Changes in Dietary Intake and Eating Behavior in Adolescents After Bariatric Surgery: an Ancillary Study to the Teen-LABS Consortium

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Abstract

Background

A growing number of studies suggest that bariatric surgery is safe and effective for adolescents with severe obesity. However, surprisingly little is known about changes in dietary intake and eating behavior of adolescents who undergo bariatric surgery.

Objective

Investigate changes in dietary intake and eating behavior of adolescents with obesity who underwent bariatric surgery (n = 119) or lifestyle modification (LM) (n = 169).

Setting

University-based health systems

Methods

A prospective investigation of 288 participants (219 female and 69 male) prior to bariatric surgery or LM and again 6, 12, and 24 months (surgery patients only) after treatment. Measures included changes in weight, macronutrient intake, eating behavior, and relevant demographic and physiological variables.

Results

Adolescents who underwent bariatric surgery experienced significantly greater weight loss than those who received LM. The two groups differed in self-reported intake of a number of macronutrients at 6 and 12 months from baseline, but not total caloric intake. Patients treated with surgery, compared to those treated with LM, also reported significantly greater reductions in a number of disordered eating symptoms. After bariatric surgery, greater weight loss from postoperative month 6 to 12 was associated with self-reported weight consciousness, craving for sweets, and consumption of zinc.

Conclusions

Adolescents who underwent bariatric surgery, compared to those who received LM, reported significantly greater reductions in weight after 1 year. They also reported greater reductions in disordered eating symptoms. These findings provide new information on changes in dietary intake and eating behavior among adolescents who undergo bariatric surgery.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    David B. Sarwer, Rebecca J. Dilks, Jacqueline C. Spitzer, Thomas A. Wadden & Renee H. Moore

  2. Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19428, USA

    David B. Sarwer & Jacqueline C. Spitzer

  3. Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Robert I. Berkowitz

  4. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Robert I. Berkowitz

  5. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Robert I. Berkowitz

  6. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Renee H. Moore

  7. University of Pennsylvania School of Nursing, Philadelphia, PA, USA

    Jesse L. Chittams

  8. Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Mary L. Brandt

  9. Division of Pediatric Surgery, Children’s Hospital of Alabama, University of Alabama, Birmingham, AL, USA

    Mike K. Chen

  10. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Anita P. Courcoulas

  11. Women and Children’s Hospital of Buffalo, Buffalo, NY, USA

    Carroll M. Harmon

  12. Division of Pediatric Surgery, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Michael A. Helmrath, Todd M. Jenkins & Thomas H. Inge

  13. Department of Pediatric Surgery, The Ohio State University College of Medicine and Nationwide Children’s Hospital, Columbus, OH, USA

    Marc P. Michalsky

  14. Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Stavra A. Xanthakos

  15. Division of Behavioral Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Meg H. Zeller

Authors
  1. David B. Sarwer
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  2. Rebecca J. Dilks
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  3. Jacqueline C. Spitzer
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  4. Robert I. Berkowitz
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  5. Thomas A. Wadden
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  6. Renee H. Moore
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  7. Jesse L. Chittams
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  8. Mary L. Brandt
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  9. Mike K. Chen
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  10. Anita P. Courcoulas
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  11. Carroll M. Harmon
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  12. Michael A. Helmrath
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  13. Marc P. Michalsky
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  14. Stavra A. Xanthakos
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  15. Meg H. Zeller
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  16. Todd M. Jenkins
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  17. Thomas H. Inge
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Corresponding author

Correspondence to David B. Sarwer.

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Funding

Work on this paper was supported, in part, by the National Institute of Diabetes and Digestive and Kidney Diseases (Grants R01-DK080738 to Dr. Sarwer and K24-DK065018 to Dr. Wadden and U01DK072493 to Dr. Inge), the Pennsylvania Department of Health SAP4100033130 to Dr. Berkowitz, and the Clinical & Translational Research Center at the University of Pennsylvania and The Children’s Hospital of Philadelphia supported by grants UL1RR024134 (NCRR) and UL1TR000003 (NCATS).

Conflict of Interest

Author A reports received consulting fees from the following: BARONova, Ethicon Endosurgery, Medtronic, and Novo Nordisk. Author B reports receiving fees for serving on the Advisory Board for Orexigen Pharmaceutical and Nutrisystem. He reports receiving grants and advisory board fees from Novo Nordisk and Weight Watchers. He also reports receiving grant funding from Eisai Pharmaceutical and royalties from Guilford Press for two edited books. Author C reports consulting fees from Sanofi Corporation and grant funding from Ethicon Endosurgery.

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Sarwer, D.B., Dilks, R.J., Spitzer, J.C. et al. Changes in Dietary Intake and Eating Behavior in Adolescents After Bariatric Surgery: an Ancillary Study to the Teen-LABS Consortium. OBES SURG 27, 3082–3091 (2017). https://doi.org/10.1007/s11695-017-2764-9

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