Problematic eating behaviors can be an influential component of weight gain. Initial management of obesity focuses on the modification of such behaviors, along with dietary changes and increasing physical activity. However, because such lifestyle changes are difficult to adopt and to sustain, the resultant weight loss using such a conservative, noninvasive approach can be variable and unsustainable.1 Similarly, despite the initial enthusiasm surrounding the successes of bariatric surgery, which has been considered to be a safe, effective way to achieve lasting, significant weight loss, studies have demonstrated substantial variability in and eventual attenuation of long-term postoperative weight loss.2,3 This variation has persisted despite the evolution of surgical procedures and techniques, thus reinforcing the need to conceptualize obesity as a disease modulated by anatomical, hormonal, genetic, and behavioral factors.
Christina A. Minami, Jonah J. Stulberg, Eric S. Hungness. Partnering Behavioral Modification With Bariatric Surgery. JAMA. 2016;316(4):448–449. doi:10.1001/jama.2016.9033