Introduction: People do not eat purely due to hunger, but also in response to life stressors and emotions. Emotional eating is linked to disordered eating behaviours and associated with reduced weight loss success and weight regain. However, as bariatric surgery results in sustained weight loss over time, it is possible that part of the success behind surgery may be due to changes in non-hungry eating. Hence, this systematic review aims to examine changes in emotional eating behaviour after bariatric surgery.
Methods: Sixteen electronic databases were searched on June 11th 2019. Studies were included if they included primary bariatric surgery patients, quantitatively assessed emotional eating behaviours, and reported emotional eating both before and after bariatric surgery. Papers were excluded if they only included revisional bariatric surgery, did not include human participants, were not in English language, or full text was not available. Study quality was assessed using the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group by the National Heart, Lung and Blood Institute.
Results: Out of 1265 studies, 23 pre-post studies were included containing 6494 participants with a range of post-operative follow up periods between 2 weeks and 48 months. Emotional eating scores dropped between 2 weeks to 12 months post-bariatric surgery, although results were mixed between 12 months to 36 months, and no longer significant in follow up over 36 months. Six studies were poor quality, 13 were fair quality, and four were good quality.
Conclusion: Emotional eating behaviour was found to be reduced in the short to medium term period following bariatric surgery, suggesting that bariatric surgery may play a role in mitigating emotional eating behaviour. These findings provide a clue to the underlying physiological mechanisms behind emotional eating, that may eventually allow for the development of targeted management for people affected by emotional eating.