Objectives: Laparoscopic sleeve gastrectomy (LSG) incidence has increased worldwide. However, a proportion of patients achieve inadequate weight loss and some experience weight regain. Little is known of the influence of eating beliefs and behaviours in response to cravings on early weight loss trajectory. This study aimed to identify the post-surgery eating cravings that predicted patients not achieving excess weight loss outcome (EWL) at 6-8 months post-LSG.

Design: A total of 106 (80.7% female) participants who underwent LSG from four sites completed the questionnaires at 4-6 weeks post-bariatric surgery and 6 months post-LSG. Achieving <40% EWL at 6-month follow-up was included as the outcome variable, and the nine subscales of the Food Cravings Questionnaire-Trait version (FCQ-T) were included as potential predictors of that change.

Methods: Logistic regression was used to examine the relationship between EWL and the nine subscales of the FCQ-T (intentions to eat, positive reinforcement, negative reinforcement, lack of control, preoccupation with food, feelings of hunger, negative affect, emotions experienced before or during food cravings or eating, and guilty feelings).

Results: Participants lost an average 64% EWL (SD = 21% EWL) 6-8 months after LSG surgery. Results indicated the overall model was significant and, of the nine variables, the emotional food craving subscale (adjusted OR = 4.19, p = .018) predicted a failure to achieve EWL.

Conclusion: Emotional food cravings experienced 4-6 weeks following LSG may predict poor weight loss outcomes at 6 months. Statement of contribution What is already known on this subject? The prevalence of obesity has reached epidemic proportions worldwide. Bariatric surgery is currently the most viable and cost-effective treatment for obesity and shows sustainability. Laparoscopic sleeve gastrectomy (LSG) is now the most common procedure. Not all patients achieve excess weight loss outcome (EWL) following LSG. What does this study add? Emotional food cravings contribute to weight loss outcomes at 6 months' post-LSG surgery. Emotional food cravings may be a maladaptive coping mechanism that represents important area for early psychological intervention.