- Title
- Diet and eating behaviour following laparoscopic adjustable gastric banding: informing dietary management practices
- Creator
- Fielding, Alison
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2013
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Obesity remains a pervasive health issue in the developed world. Surgery is the most efficacious treatment option available for obese individuals at present, with laparoscopic adjustable gastric banding (LAGB) representing one of the most popular surgical obesity treatments worldwide. Despite the relative efficacy of LAGB, successful weight loss is not guaranteed. Ongoing dietary follow-up is recognised as a crucial element in determining the success of LAGB; yet the evidence base guiding best-practice dietary management for the optimisation of weight loss and other dietrelated outcomes is currently limited. The overarching aim of this thesis is to contribute to the evidence base guiding the dietary management of individuals who have had LAGB, with focus on weight loss, dietary intake and eating behaviour outcomes. Three components of research were undertaken to meet this aim. Systematic reviews of dietary intake and eating behaviour after LAGB examined the existing evidence base for these outcomes including their relationship with weight loss outcomes. These reviews highlight the paucity of evidence currently available to guide the best-practice dietary management of individuals who have had LAGB; and emphasise the need for well-designed interventions to better establish evidence-based strategies for optimising weight loss after surgery. Enhanced protein intake was identified as a dietary strategy of potential value in this context. A pilot dietary intervention (n=47, 38 females and 9 males) was undertaken to examine the feasibility of a protein-enriched diet in the first six months after LAGB for the optimisation of weight loss and body composition outcomes. Compliance with the diet was problematic; indicating that adherence difficulties may negate the feasibility and potential benefits of a protein-enriched diet in the early months after surgery. The relationship between eating behaviour and weight loss, dietary intake, food tolerance and quality of life in the first 12 months after surgery was also examined from pilot intervention data. Higher post-operative disinhibition scores were significantly associated with lower percentage weight loss, supporting the wider literature indicating that uncontrolled eating behaviours can negatively impact on weight loss after surgery. A broad ranging cross-sectional survey (n=67, 55 females and 12 males) examining dietary intake, eating behaviour, food tolerance, weight loss and quality of life within the first two years after LAGB was also conducted. This study suggested that disinhibited eating may remain significantly higher in individuals who have had LAGB than the general community. No postoperative dietary or eating behaviour related variables were strongly associated with reported weight loss or quality of life after surgery. Overall, the findings of this thesis support that poor compliance with dietary modification and uncontrolled eating behaviour represent important targets for dietary and behavioural interventions aimed at optimising weight loss and other outcomes after LAGB. There remains a critical need for such interventional research in this area, particularly for individuals identified as ‘at risk’ of poorer outcomes. The findings of this thesis have important implications for future research into the best-practice dietary management of individuals who have LAGB; and will be of value to a diversity of health professionals involved in the follow-up care of LAGB patients, including dietitians, psychologists, nurses and surgeons.
- Subject
- laparoscopic adjustable gastric banding; diet; eating behaviour; obesity; weight loss; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1036914
- Identifier
- uon:13380
- Rights
- Copyright 2013 Alison Fielding
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 198 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 9 MB | Adobe Acrobat PDF | View Details Download |