Food cravings and food consumption after Roux-en-Y gastric bypass versus cholecystectomy

Background Food cravings and consumption of craved foods after Roux-en-Y gastric bypass (RYGB) are poorly understood. Food cravings after bariatric surgery may explain why some patients fail to change eating behaviors after RYGB, and understanding these cravings may provide better information for nutritional counseling to either enhance weight loss or prevent weight regain. Objectives To study cravings in RYGB patients and compare them with cholecystectomy (CC) control patients. Setting This study took place in a university hospital. Methods RYGB patients (n = 50) and CC control patients (n = 38) completed a validated food craving inventory before surgery and at 2 and 6 weeks postoperatively. In addition, RYGB patients completed the food craving inventory at 12, 24, 36, and 52 weeks postoperatively. A linear mixed-effect model with a first-order autoregressive structure for correlations was used to evaluate changes in food consumption and food cravings between visits. Correlations between food cravings and body mass index (BMI) or weight changes before and after RYGB were assessed with Spearman correlation coefficients. P<.05 was considered statistically significant. Results After RYGB, food consumption decreased significantly compared with CC control patients and was lowest at 2 weeks. Consumption progressively increased over time in the first year but remained significantly less than that from presurgery. In addition, a higher preoperative BMI was found to correlate moderately with higher preoperative cravings of the total of all 4 food groups studied (r = .3, P = .04); high-fat foods (r = .3, P = .04); and sweets (r = .3, P = .03). However, with the exception of preoperative cravings for high-fat foods, these scores were not predictive of changes in BMI after surgery. Overall, RYGB did not significantly affect food cravings after surgery compared with CC control patients. Conclusion These findings indicate that RYGB may limit food consumption but does not affect the drive to consume certain types of food. Because food cravings are high in patients with obesity before surgery and remain high after surgery, these findings suggest a possible reason for noncompliance with dietary recommendations after RYGB.