How does patient reported satiety, hunger, and appetite change after metabolic and bariatric surgery? A comparison between sleeve gastrectomy and Roux-en-Y gastric bypass

Background: Satiety, cravings, and appetite have a behavioral impact on eating and may be associated with obesity. There are limited data evaluating the trajectory of hunger after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). Methods: Metabolic and bariatric surgery (MBS) patients were given the Daily Eats questionnaire at their preoperative and postoperative appointments. Daily Eats is a validated survey which asks patients to rate hunger, appetite, cravings, and satiety on a scale of 0–10. Cross-sectional data were obtained at five timepoints including preoperative visits and postoperative appointments at monthly intervals including: 0–12, 12–24, 24–36, and > 36. Average Daily Eats scores in the postoperative setting for SG and RYGB patients were compared using independent sample t-tests with a p-value of < 0.05 indicating significance. Results: There were 3898 Daily Eats questionnaires completed (2334 preoperative, 996 postoperative SG, 568 postoperative RYGB). Patient-reported outcome measures (PROMs) survey compliance was 77% at the time of this study with 2334/2537 (92%) preoperative surveys completed and 1564/2523 (62%) postoperative surveys completed. Patients who underwent SG reported significantly higher scores for hunger (4.87 ± 2.33 vs. 3.53 ± 2.16; p < 0.01) and appetite (5.07 ± 2.05 vs. 3.85 ± 1.76; p < 0.01) at 24–36 months when compared to patients who underwent RYGB. Patients who were > 36 months after SG reported significantly higher scores for hunger (4.58 ± 2.21 vs. 3.94 ± 2.39; p < 0.01) and appetite (4.67 ± 1.90 vs. 4.08 ± 2.27; p < 0.01) when compared to patients who underwent RYGB. Conclusion: Compared to RYGB, patients who underwent SG reported significantly more long-term hunger and appetite. PROMs after MBS may enable tailored postoperative care by procedure and improve preoperative counseling by illustrating how hunger-related sensations evolve differently depending on the surgical procedure.