Dietary patterns of African American and Caucasian females seeking bariatric surgery
Authors: McLean Kendall , Moore Carolyn , Miketinas Derek , Champagne Catherine 
Published: November 2023

Surgical interventions may be more effective for severely obese individuals to reduce weight and improve or resolve obesity‐related medical conditions compared to non‐surgical interventions. While bariatric surgery typically results in substantial weight loss, success following surgery may also depend on the implementation of several dietary changes. Pre‐surgical dietary assessment is needed to identify usual dietary intake patterns and short term intervention prior to surgery, along with elucidating potential dietary issues following surgery. Heads Up was an observational study sponsored by a large benefits management group that examined both surgical and nonsurgical approaches to weight management in obese adults. The objectives of the present study were to identify the frequency of consumption of various food and beverage groups prior to surgery and to examine possible associations between dietary intake and certain behaviors (e.g. self‐weighing frequency, amount of previous weight loss attempts, etc.). This study utilized a pre‐surgical dietary assessment interview to describe the habitual diet patterns and behaviors of African American and Caucasian obese females (n=200) seeking the surgical intervention of the Heads Up study. Differences between racial groups were tested using a two‐way ANOVA and Pearson's correlations were used to examine associations between the variables of interest. The significance level for all tests was set at p < 0.05 and all analyses were performed using SAS software, Version 9.4. Mean body mass index (BMI) of the females was 48.9 ± 5.8 kg/m2. Descriptive analyses indicated that participants reported consuming fast food 2.9 ± 2.6 times per week and fried foods 2.1 ± 1.8 times per week. Approximately 27% of females reported regular consumption of sugar‐sweetened sodas and 23% reported regular consumption of sugar‐sweetened tea beverages. Pearson Correlation coefficients indicated that BMI was inversely associated with fruit consumption (r = −0.16, p<0.05). Body weight was inversely associated with fruit consumption (r = −0.19, p<0.05) and vegetable consumption (r = −0.19, p<0.05). Self‐weighing frequency was inversely associated with fast food consumption (r = −0.24, p<0.001), fried food consumption (r = −0.17, p<0.05) and consumption of sweets (r = −0.16, p<0.05). Compared to Caucasians, African Americans reported more frequent, weekly consumption of fast food (3.4 ± 3.0 vs 1.9 ± 1.7, p<0.01) and more frequent, regular consumption of sugar‐sweetened sodas (34.8% vs 19.4%, p<0.05). In contrast, Caucasians reported more frequent, weekly consumption of vegetables (6.1 ± 2.7 vs 5.2 ± 2.3, p<0.01) than African Americans. Findings suggest that unhealthful dietary choices such as frequent consumption of fast foods, fried foods and sugar‐sweetened beverages are common among women seeking bariatric surgery. In conclusion, usual dietary intake is important to address during pre‐surgical dietary assessments to influence potential surgical success. Follow‐up studies should examine the dietary interview instrument's ability to predict dietary adherence and weight loss success following surgery.Support or Funding InformationState of Louisiana, Office of Group Benefits