Table 2.
Problematic eating behaviors associated with weight regain and intervention approaches following bariatric surgery
| Eating Behavior | Problem | Intervention |
|---|---|---|
| Erratic eating | Inconsistent/unplanned eating schedule | Preplan approximate timing and appropriate spacing of meals throughout the day based on daily schedule |
| Meal skipping | Not eating for an extended time period leading to subsequent hunger and overeating | Plan meals ahead of time; create a shopping list to ensure selected food and appropriate amounts are available to prepare these meals |
| Unhealthy food and beverage selections | Frequent intake of high-calorie/processed meals and snacks including fast food/take-out, fried food, concentrated sweets, and refined carbohydrates; calorie-rich beverages such as soda and juices | Education on balanced meal preparation containing protein and fiber-rich sources to help optimize satiety; encourage cooking classes and/or online cooking resources |
| Nibbling/Grazing | Continuous/repetitive and unplanned eating of modest portions of food throughout the day; often associated with previous binge-eating behaviors; leads to excessive cumulative energy intake | Avoidance of skipping meals; appropriate meal portion sizes (1/2-1 cup). Identify triggers including stress, boredom, and emotional factors or engaging in other activities such as watching television |
| Night eating | Consuming more calories before sleep favors positive energy balance and weight gain | Schedule time for meals during the day; self-monitor using food journal |
| Inappropriate portions | Portion sizes beyond the feeling of fullness resulting in discomfort | Weigh and measure foods, use smaller plates and utensils, and limit volume to 1 cup of food per meal |
| Alcohol use | Excess nonnutritive calories; promotes increased hunger, food cravings, and compromises judgment regarding proper food selection | Avoid or limit alcohol consumption; consider referral to treatment program if unable to control behavior |
| Insufficient protein and fiber intake | Protein and fiber promote optimal satiation; protein-rich foods optimize muscle integrity and energy metabolism | Education on quality sources of protein and fiber; assist with meal planning to achieve appropriate intake |
| Drinking fluids with meals | Potential enlargement of the gastric pouch and outlet with repeated behavior; leads to rapid emptying of the stomach | Delay fluid intake at least 30 minutes after consuming solid food |