Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19

Abstract

Background: Recent studies suggest that eating habits are an area particularly affected by the lockdown imposed by many countries to curb the COVID-19 epidemic. Individuals that received bariatric surgery may represent a particularly susceptible population to the adverse effects of lockdown for its potential impact on eating, psychological, and weight loss outcomes.

Objectives: This study seeks to investigate the incremental impact of COVID-19 lockdown on treatment outcomes of postbariatric patients in the risk period for weight regain.

Setting: Main hospital center.

Methods: This work uses data from an ongoing longitudinal study of bariatric patients assessed before surgery (T₀), 1.5 years after sugery (T₁), and 3 years after surgery (T₂). Two independent groups were compared: the COVID-19_Group (n = 35) where T₀ and T₁ assessments were conducted before the pandemic started and T₂ assessment was conducted at the end of the mandatory COVID-19 lockdown; and the NonCOVID-19_Group (n = 66), covering patients who completed T₀, T₁, and T₂ assessments before the epidemic began. Assessment included self-report measures for disordered eating, negative urgency, depression, anxiety, stress, and weight outcomes.

Results: General linear models for repeated measures showed that the COVID-19_Group presented significantly higher weight concern (F = 8.403, P = .005, ƞ²_p = .094), grazing behavior (F = 7.166, P = .009, ƞ²_p = .076), and negative urgency (F = 4.522, P = .036, ƞ²_p = .05) than the NonCOVID-19_Group. The COVID-19_Group also showed less total weight loss (F = 4.029, P = .05, ƞ²_p = .04) and larger weight regain at T₂, with more COVID-19_Group participants experiencing excessive weight regain (20% versus 4.5%).

Conclusion: These results show evidence for the impact of the coronavirus outbreak on eating-related psychopathology and weight outcomes in postbariatric surgery patients.

Keywords: Bariatric surgery; COVID-19 pandemic; Disordered eating psychopathology; Grazing behavior; Weight outcomes.

Fig. 1

Scores on the psychological measures throughout the different assessment times (T₀ = presurgery; T₁ = 1.5 yr after surgery; T₂ = 3 yr after surgery). (a) Weight concern subscale of the Eating Disorder Examination Questionnaire (EDE-Q); (b) Scores on the negative urgency scale of the Urgency, Premeditation, Perseverance, and Sensation Seeking Scales (UPPS); (c) Scores on the repetitive eating subscale of the Repetitive Eating Questionnaire (Rep(eat)-Q); (d) Scores on the compulsive grazing subscale of the Repetitive Eating Questionnaire (Rep(eat)-Q). ∗P < .05; ∗∗P < .01. Note: for the COVID-19_Group, T₀ and T₁ took place before the pandemic started, and T₂ at the end of the lockdown. The NonCOVID-19_Group completed T₀, T₁ and T₂, assessments before the epidemic began.

Fig. 2

Weight loss regained (%WLRegained) throughout the different assessment times (T₁ = 1.5 yr after surgery; T₂ = 3 yr after surgery). ∗P < .05; ∗∗P < .01. Note: for the COVID-19_Group, T₀ and T₁ took place before the pandemic started, and T₂ at the end of the lockdown. The NonCOVID-19_Group completed T₀, T₁ and T₂ assessment before the epidemic began.