The Relationship of Eating Behaviors, Hunger Control, and Physical Activity to Weight Loss and Quality of Life in Laparoscopic Adjustable Gastric Banding Patients

Abstract

Gastric banding as a weight loss surgery has increased in popularity in the United States since its approval by the Food and Drug Administration in 2001. Successful weight loss after weight loss surgery is most frequently defined as greater than 50% of excess weight loss (EWL). Systematic reviews show that the band is widely effective in achieving successful weight loss in most patients; however, individual studies show more inconsistent outcomes. Weight loss outcomes after gastric banding surgery at Virginia Commonwealth Health System were less than 50% EWL at 1 and 2 years. A retrospective, descriptive study sought to answer the following questions: (a) what is the relationship between physical activity, eating behaviors and hunger control on weight loss and quality of life after gastric banding surgery, and (b) does successful weight loss at 1 year predict successful weight loss at 2 years?Weight loss outcomes at 34.6% at 1 year and 39.7% at 2 years, were less than the established success rate of greater than 50% EWL. However, most patients lost some weight and demonstrated a significant improvement in most domains of health-related quality of life. Participation in physical activity increased between preoperative baseline to year 1 but decreased by 2 years. There was a significant relationship between participation in greater than 150 minutes per week of moderate or vigorous physical activity and adequate weight loss (p = 0.025) and participation in health enhancing physical activities and adequate weight loss (p < 0.05). There was no statistically significant relationship noted between eating behaviors and the percentage of EWL at 1 or 2 years. There was a significant relationship between degree of hunger reported by patients and successful weight loss at 1 year (p < 0.05). In addition, 1-year weight loss is a significant predictor for 2-year weight loss. Based on the findings of this study, it is recommended that gastric banding patients participate in at least 150 minutes per week of moderate to vigorous physical activity. Moreover, an increased focus on early reduction of hunger in the banding patient by development of band adjustment protocols may enhance weight loss.