1533-P: Impact of Hunger and Disinhibition on Weight Trajectory: One and 15 Years after Biliopancreatic Diversion with Duodenal Switch

Introduction and Objective: Biliopancreatic diversion with duodenal switch(BPD/DS) surgery is the most effective approach for the management of severe obesity, but weight regain may occur in the long term. Eating behaviors in this context has not been studied. This study examines the evolution of eating behaviors at 1 year and over a 15-year period after BPD/DS in relation to weight changes. Methods: Medical history, Three Factor Eating Questionnaire/anthropometric measurement were completed at each visit. The surgery group (n=46) was assessed at baseline, at 1 and 15 years after BPD/DS. The control group (with severe obesity) was evaluated at baseline and 1 year. Long-term follow-up at 15 years conducted exclusively in the surgery group. Weight regains was defined as a weight increment ≥10% between the 1 and 15-years. Results: At baseline, the BPD/DS and control groups were similar in age, sex, weight and eating behavior. At 1 year, weight decreased significatively in the surgery group (-37.1±6.9%) compared to the control group (-0.5±5.0%). The surgery group showed a reduction in dietary disinhibition in comparison to the control group (-1.2±1.1 vs.-0.4±0.9, p=0.007). Fifteen years after surgery, 22 patients (48%) experienced weight regain of at least 10%. Patients with weight regain were younger (56±10 vs.62±9 years, p=0.06) had lower rates of hypertension (14 vs.46%, p=0.02) and type 2 diabetes (0 vs. 17%, p=0.04) than those who had maintained their weight loss. In patient who experienced weight regain, hunger increased (0.5±0.6 to 1.0±0.8, p=0.02), as did dietary disinhibition (3.1±0.3 to3.7±1.1, p=0.03), whereas both remained stable in patient without weight regain. Conclusion: BPD/DS may improve eating behaviors, notably by reducing dietary disinhibition within the first year. At 15 years, individuals with weight regain tend to be younger and show higher levels of hunger sensitivity and disinhibition. These findings suggest behavioral factors likely play an important role in long-term weight maintenance following BPD/DS. Disclosure S.S. Caroline: None. P. Poirier: None. M. Pettigrew: None. M. Piché: None. A. Auclair: None.