Sweet Eating is not a Predictor of Outcome after Lap-Band^® Placement. Can we Finally Bury the Myth?

Background: It is common belief that sweet eaters will do poorly after gastric restrictive surgery.There is scant evidence for this and significant evidence that sweet eating behavior is not predictive of weight outcome. Preoperative and current sweet eating behavior was assessed in subjects who have had Lap-Band^® surgery, to find if this influenced weight outcomes. Method: 200 unselected patients who had bands inserted for >1 year completed a questionaire regarding preoperative sweet eating behavior. The last 100 patients also reported current sweet eating behavior. Sweet eating was scored using a standard dietary questionnaire. Results: Mean±SD % excess weight loss at 1 year (%EWL1) for the 100 with the highest preoperative sweet eating scores (SES) was 47.1±16% compared with a loss of 48.2±16% by those with the lowest SES (P=0.64). Analysis showed no significant linear or non-linear correlation between the SES and the %EWL. For the highest quintile of SES, the EWL1 was 47.3±14% and for the lowest was 46.1±16% (NS). Sweet eaters were younger (r=-0.21, P=0.003) and had higher fasting insulin concentrations (r=-0.18, P=0.03). Preoperative SES had no influence on %EWL1 after controlling for factors known to influence weight loss. %EWL at 2 years (n=130) and 3 years (n=88) were not different for sweet eaters and non-sweet eaters. Current sweet eating tendency (n=100) also had no impact on %EWL. Conclusion: Sweet eaters do not have less favorable weight outcomes following Lap-Band^® surgery. Our study confirms the findings of two other major studies. Sweet eating behavior should not be used as a preoperative selection criterion for bariatric surgery.