Food Intake and Eating Behavior After Bariatric Surgery

Abstract

Obesity is an escalating global chronic disease. Bariatric surgery is a very efficacious treatment for obesity and its comorbidities. Alterations to gastrointestinal anatomy during bariatric surgery result in neurological and physiological changes affecting hypothalamic signaling, gut hormones, bile acids, and gut microbiota, which coalesce to exert a profound influence on eating behavior. A thorough understanding of the mechanisms underlying eating behavior is essential in the management of patients after bariatric surgery. Studies investigating candidate mechanisms have expanded dramatically in the last decade. Herein we review the proposed mechanisms governing changes in eating behavior, food intake, and body weight after bariatric surgery. Additive or synergistic effects of both conditioned and unconditioned factors likely account for the complete picture of changes in eating behavior. Considered application of strategies designed to support the underlying principles governing changes in eating behavior holds promise as a means of optimizing responses to surgery and long-term outcomes.

Effect of Short-Term Transcutaneous Vagus Nerve Stimulation (tVNS) on Brain Processing of Food Cues: An Electrophysiological Study

“…Between 1975 and 2016, the worldwide prevalence of obesity almost tripled in adults, whereas in children and adolescents (5-19 years), it increased nearly fivefold [World Health Organization (WHO), 2020]. In contrast, current treatment approaches, such as behavioral interventions, pharmacological treatments, and bariatric surgery, show limited effectiveness, are costly, or are burdened with side effects (Butryn et al, 2011;Kakkar and Dahiya, 2015;Al-Najim et al, 2018). Effective treatment options for the management of body weight are relevant because increased body weight is associated with various diseases (Afshin et al, 2017).…”

Double‐blinded, randomized, and controlled study on the effects of canagliflozin after bariatric surgery: A pilot study

“…If weight loss is facilitated via diet and exercise, the homeostatic response is hyperphagia . By contrast, participants who have undergone bariatric surgery have a reduction in hunger and increase in satiety because of the proposed changes to the homeostatic control of the body fat set point . There are, however, interindividual differences in weight loss outcomes; specifically, some patients are resistant to the positive effects of bariatric surgery, and as a result, caloric intake markedly increases .…”

Improvement in Uncontrolled Eating Behavior after Laparoscopic Sleeve Gastrectomy Is Associated with Alterations in the Brain–Gut–Microbiome Axis in Obese Women

“…In obesity, the neuronal mechanisms that modulate the motivation to consume food are disrupted, resulting in impaired control and overconsumption of highly hedonic foods [ 53 ]. In prior published studies, bariatric surgery often leads to changes in food preference, meal frequency and meal size [ 54 , 55 ]. The exact reason for this change is likely multifactorial and includes alterations in appetite regulating gastrointestinal hormones, patient motivation, and changes in central nervous signaling [ 54 , 56 ].…”

“…In prior published studies, bariatric surgery often leads to changes in food preference, meal frequency and meal size [ 54 , 55 ]. The exact reason for this change is likely multifactorial and includes alterations in appetite regulating gastrointestinal hormones, patient motivation, and changes in central nervous signaling [ 54 , 56 ]. Similar to other studies, we found, among our study subjects, a high incidence of addiction-like behaviors to food which were improved after surgery [ 57 ].…”