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The Prognostic Value of the Dutch Sweet Eating Questionnaire on Weight Loss After Metabolic Surgery: a Randomized Controlled Trial

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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) have shown different weight loss results. These differences might be partly due to dum** after LRYGB, forcing sweet eaters to switch to a healthy diet. The Dutch Sweet Eating Questionnaire (DSEQ) is validated to measure sweet eating. This study aims to investigate if sweet eating measured with the DSEQ influences weight loss.

Methods

In this multicenter randomized controlled trial, patients were included between 2013 and 2017 in two Dutch high-volume hospitals, and randomized with a 1:1 ratio between LRYGB and LSG. Primary outcome measure was weight loss. Secondary outcome measure was sweet eating behavior, measured with the DSEQ. Data was collected at baseline, 1 year and 2 years postoperatively.

Results

Data was analyzed of 623 patients who underwent LRYGB (n = 308; 49.4%) or LSG (n = 315; 50.6%). Follow-up rates at 2 years postoperative were 67.1% for weight and 35.3% for DSEQ. At 2 years postoperative, mean BMI was significantly higher after LSG than LRYGB (respectively 30.88 versus 28.87 kg/m2, p < 0.001), and the percentage of sweet eaters was significantly higher after LSG than LRYGB (respectively 8.6% versus 2.6%, p = 0.049). None of the preoperative sweet eaters were sweet eaters 2 years after LRYGB (0.0%), versus 11.8% 2 years after LSG. No correlation was found between postoperative sweet eating behavior and %EBMIL.

Conclusion

No significant correlation was found between preoperative or postoperative sweet eating measured with the DSEQ and weight loss. The decision-making for the procedure type is more complex than weight loss and dietary habits, and should also involve quality of life and presence of comorbidities. These factors should be addressed in future research along with longer term results.

Trial Registration

Dutch Trial Register NTR-4741

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Abbreviations

BMI:

Body mass index

DSEQ:

Dutch sweet eating questionnaire

EBMIL:

Excess body mass index loss

ERABS:

Enhanced recovery after bariatric surgery

GERD:

Gastroesophageal reflux disease

IFSO:

International Federation for the Surgery of Obesity and Metabolic Disorders

LMWH:

Low molecular weight heparin

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

LSG:

Laparoscopic sleeve gastrectomy

NSE:

Non-sweet eaters

SE:

Sweet eaters

T2D:

Type 2 diabetes

TWL:

Total weight loss

TWOR:

Toetsingscommissie wetenschappelijk onderzoek Rotterdam

VTE:

Venous thromboembolic events

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Author notes

  1. L. U. Biter and M. Leeman contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands

    L. U. Biter, M. Leeman, I. Friskes, M. der Kinderen, J. A. Apers, M. Dunkelgrun & J. F. Zengerink

  2. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands

    J. F. Smulders

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  1. L. U. Biter
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  2. M. Leeman
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  3. I. Friskes
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  4. M. der Kinderen
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  6. M. Dunkelgrun
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Correspondence to M. Leeman.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the institutional review board (IRB) and the regional Medical Research Ethics Committee TWOR, Rotterdam, the Netherlands (protocol number 2011-48).

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Informed consent was obtained from all individual participants included in the study.

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Biter, L.U., Leeman, M., Friskes, I. et al. The Prognostic Value of the Dutch Sweet Eating Questionnaire on Weight Loss After Metabolic Surgery: a Randomized Controlled Trial. OBES SURG 30, 2497–2504 (2020). https://doi.org/10.1007/s11695-020-04527-y

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