Changes in Hedonic Hunger and Problematic Eating Behaviors Following Bariatric Surgery: A Comparative Study of Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy

Abstract

Background/Objective: This study aims to examine changes in hedonic hunger and problematic eating behaviors over a 24-week follow-up period after sleeve gastrectomy and Roux-en-Y gastric bypass and to compare differences between the two surgical procedures. Methods: This prospective observational study included 144 adults who underwent sleeve gastrectomy (n = 74) or Roux-en-Y gastric bypass (n = 70). Hedonic hunger was assessed using the Power of Food Scale, and problematic eating behaviors were evaluated with the Eating Disorder Examination Questionnaire. Data was collected one week before surgery and 24 weeks postoperatively through face-to-face interviews. Results: At the 24-week follow-up, participants who underwent gastric bypass had higher total Power of Food Scale scores than those who underwent sleeve gastrectomy (2.42 vs. 2.15), although reductions from baseline were not significantly different (-1.31 vs. -1.16, p = 0.136). Both procedures resulted in significant decreases in total Eating Disorder Examination Questionnaire scores (sleeve gastrectomy: 2.37 to 1.00, p < 0.01; gastric bypass: 2.41 to 1.36, p < 0.01), as well as in Eating Concern, Shape Concern, and Weight Concern subgroups. Reductions in Eating Disorder Examination Questionnaire total score and in Shape Concern and Weight Concern subgroups score were greater after sleeve gastrectomy (-1.37 vs. -1.05, p = 0.030). Total weight loss percentage was positively correlated with decreases in Eating Disorder Examination Questionnaire scores in both groups (p = 0.010) and was significantly associated with Power of Food Scale reductions only in sleeve gastrectomy (r = 0.163, p = 0.014). Conclusions: Both procedures reduce hedonic hunger and problematic eating behaviors, but the magnitude of change and its effect on weight loss may vary by surgical method.