Are You Craving Sweets?

By Cynthia K. Buffington, PhD

Before your surgery, were you a sweet eater? Did you crave sweets, particularly when you were under stress or emotionally upset? What happened after your surgery? Do you still crave sweets? Has your sweet cravings returned?

Studies^1-2 find that the majority of individuals with severe obesity crave sweets and eat excessive amounts of sweets foods, particularly in response to stress and emotional distress. Sweet craving, in turn, is associated with an increase in consumption of simple carbohydrates (sugar, high fructose corn syrup) and a reduction in the amount of fat that is burned by the body. An increase in food intake and a decrease in fat utilization results in greater fat storage and weight gain.

Based upon the association between sweet eating and increasing body size, it would seem reasonable to assume that sweet cravers/eaters would lose less weight after surgery than would non-sweet cravers/eater. One study³ involving a small number of study participants found that sweet eaters who have a restrictive surgery lose less weight than those who are non-sweet eaters. Because of these early findings, many surgeons recommend that their patients who are sweet eaters not have a restrictive purely surgical procedure, i.e. gastric band, sleeve gastrectomy, gastroplasty.

Subsequent studies^1,4-7 involving hundreds of patients found that sweet cravings/eating before surgery is NOT a predictor of weight loss success after surgery. People who are sweet eaters before surgery lose as much weight as do non-sweet eaters following either purely restrictive procedures or restrictive plus malabsorptive procedures, such as the gastric bypass. Such findings suggest that being a sweet craver before surgery may not affect your weight loss success, regardless of surgical procedure. However, this may not be the case for the person whose sugar craving returns after surgery or who develop sweet cravings postoperatively.

A recent study¹ found that surgery (the gastric bypass and sleeve gastrectomy but not the band) is highly effective in reducing sugar cravings and the desire for sweets. With sleeve gastrectomy and gastric bypass, 2/3 of individuals who were sweet cravers before their surgery no longer were sweet cravers 2 to 3 months postoperatively. These individuals, as compared to those who continued to crave sweets after surgery or developed sweet cravings post-surgery, lost considerably MORE weight and experienced less weight regain. Weight loss for the non-sweet cravers following the sleeve gastrectomy or gastric bypass was a respective 1.7 and 1.6 times greater than for the sweet cravers. These findings suggest that sweet craving after surgery may jeopardize weight loss success.

References:

1. Ferguson K et al.  Gastric bypass and the sleeve gastrectomy improve sugar cravings postoperatively.  (2011 accepted for ASMBS presentation).
2. Cowan GSM, Jr. et al.  Carbohydrate craving in the etiology of obesity. Obes Res 1999; 7:68S.
3. Sugerman HJ et al. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters.  Ann Surg 1987; 613-624.
4. Lindroos AK et al. Weight change in relation to intake of sugar and sweet foods.  Int J Obes Relat Metab Disord 1996; 20:634-43.
5. Busetto L et al.  Outcome predictors in morbidly obese recipients of an adjustable gastric band.  Obes Surg 2002; 12:83-92.
6. Hudson S et al.  Sweet eating is not a predictor of outcome after Lap-Band Placement.  Can we finally bury the myth?  Obes Surg 2002; 12:789-94.
7. Madan AK et al.  Preoperative carbohydrate addiction does not predict weight loss after laparoscopic gastric bypass.  Obes Surg 2006; 16:879-82.