The reduction in energy intake after RYGB and SG surgery and the subsequent weight loss seems to be primarily related to a reduction in portion sizes and not by changes in food preferences towards less energy-dense foods. These results underline the necessity of investigating eating behavior by targeting direct behavior.

Objective Using an ad libitum buffet meal targeting direct behavior, the authors of the current study previously reported no effect of Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgery on food preferences 6 months after surgery. The current study investigated changes in food preferences at 18 months after surgery and whether changes in food preferences at 6 months predicted weight loss. Methods Twenty food items separated into the following food categories were served at the buffet meal: high‐fat, low‐fat, sweet, savory, high‐fat savory, high‐fat sweet, low‐fat savory, and low‐fat sweet. Energy intake and intake from each of the food items were registered. Energy intake prior to the meal was standardized. Results Thirty‐nine subjects completed visits before surgery and 18 months following RYGB (n = 29) and SG (n = 10) surgery. Energy intake decreased 41% (4,470 ± 209 kJ vs. 2,618 ± 209 kJ, P < 0.001), but no change occurred in relative energy intake from any of the food categories (all P ≥ 0.23), energy density (P = 0.20), or macronutrient intake (all P ≥ 0.28). However, changes in high‐fat food intake, protein intake, energy intake, and energy density at 6 months predicted weight loss at 18 months (P ≤ 0.02). Conclusions RYGB surgery and SG surgery do not affect food preferences. However, changes in food preferences seem to be predictive of weight loss.

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