(P13-29-26) Association Between Multiple Eating Behavior Dimensions and Weight Regain Following Bariatric Surgery

Objectives: To evaluate the association between various eating behavior dimensions, including binge eating, grazing, loss of control, and cognitive restraint, with weight regain in a post-bariatric surgery population.

Methods: This cross-sectional study included 92 adults (mean age: 50.5 years) who underwent sleeve gastrectomy (71%) or Roux-en-Y gastric bypass (29%) at least 18 months ago and regained 5% or more weight relative to their post-surgery nadir weight. Weight regain (%) was log-transformed to normalize distribution. Eating behaviors were assessed using the Binge Eating Scale (BES), Grazing Scale (GRAZ), Loss of Control Over Eating Scale (LOCES), and the 18-item Three-Factor Eating Questionnaire (TFEQ-R18). Associations were tested using Pearson and Kendall correlations, followed by linear regression models adjusted for age, months since surgery, surgery type, and glycemic status.

Results: Bivariate correlations between log-transformed weight regain and BES (𝑟 = -0.063, 𝑝 = 0.55), GRAZ (𝑟 = -0.029, 𝑝 = 0.78), LOCES (𝑟 = -0.023, 𝑝 = 0.83), TFEQ Uncontrolled (𝑟 = -0.071, 𝑝 = 0.50) and Emotional Eating (𝑟 = -0.074, 𝑝 = 0.48) were not statistically significant, and there were no significant interactions between these eating behaviors and surgical or patient characteristics in predicting weight regain. Although there were no significant associations in the regression analyses with or without adjustment for other variables, in the regression analysis of log-transformed weight regain on TFEQ Cognitive Restraint (CR) after adjustment for age, there was a significant interaction between CR and age (β = 0.0007, 95% CI: 0.0001, 0.00013; 𝑝 = 0.020) indicating that the association between CR and weight regain was stronger in older patients. Subgroup analysis demonstrated a significant positive association in the 60-70 age group (n=15, β=0.014, 𝑝=0.013).

Conclusions: In post-bariatric surgery patients, current binge eating, grazing, and loss of control eating behaviors did not predict weight regain; however, high cognitive restraint was associated with weight regain in older adults. This counterintuitive finding warrants further investigation into how dietary restriction strategies may paradoxically promote weight regain in this population.

Funding Sources: This research was supported by the NIH.