A recent study found that food tolerance and gastrointestinal quality of life was best after sleeve gastrectomy approximately 2 to 4 years after surgery compared to Roux-en-Y gastric bypass and adjustable gastric banding.
The impact of bariatric surgery on quality of eating and food tolerance is an issue that is not always considered, yet these factors can greatly affect a persons life. Bariatric surgery forces patients to greatly reduce their food intake and drastically change their eating habits.
Although bariatric surgery can bring about significant weight loss and improvements in obesity comorbidities, the procedures are also often associated with reduced food tolerance and sometimes frequent vomiting, which may cause nutritional deficiencies and negatively affect quality of life.
This is one of the few studies to investigate and compare food tolerance and gastrointestinal quality of life following three of the most popular bariatric procedures: adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGBP), and sleeve gastrectomy (SG).
For the study, participants (including pre-surgery controls) completed two questionnaires: a food tolerance questionnaire (n=129) and a Gastrointestinal Quality of Life Index (GIQLI) (n=119). The study examined outcomes at approximately 2 to 4 years post-surgery. A statistical analysis was performed and the results were calculated to evaluate relationships between food tolerance and GIQLI scores.
The results showed:
- Food tolerance was highest in the control and SG groups, lowest in the AGB group
- Gastrointestinal quality of life was highest in the SG group, ranking significantly greater than AGB and control groups
- Median excess weight loss achieved was SG (76.3%), RYGBP (76.5%), and AGB (38.2%)
- A significant positive relationship between food tolerance and gastrointestinal quality of life was confirmed
The causes for food intolerance and gastrointestinal quality of life can vary between bariatric surgeries. With some procedures, the intake of specific types of food is limited as they cannot be digested well. Specific diet guidelines and problematic foods to avoid following bariatric surgery will be different for each procedure.
The diet after sleeve gastrectomy is the least restrictive in the specific types of food that can be consumed, as it primarily works by reducing hunger and limiting the quantity of food rather than the types of food that can be eaten. Gastric bypass forces avoidance of sweets due to dumping syndrome, while adjustable gastric banding limits many food types due to difficulty in digestion.
As bariatric surgery leads to lifelong changes, it is important for prospective bariatric surgery patients to discuss food tolerance and quality of eating issues with their bariatric surgeon. Knowing the differences between the types of various types of bariatric surgery before undergoing a procedure can help you choose the best option for your situation.
The study “Food Tolerance and Gastrointestinal Quality of Life Following Three Bariatric Procedures: Adjustable Gastric Banding, Roux-en-Y Gastric Bypass, and Sleeve Gastrectomy” was published in the December edition of Obesity Journal, the Official Journal of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO).
