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Taste insensitivity after bariatric surgery influenced weight loss
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Patient-reported decreases in taste intensity after bariatric surgery were associated with increased excess weight loss, according to research presented at Obesity Week 2014.
“One aspect of why people may gain weight, or a consequence of having weight, is they are more taste insensitive,” John M. Morton, MD, of Stanford University School of Medicine, told Endocrine Today. “While some people may be satisfied with taste and don’t eat as much, others may be looking to get more appreciation from food; what they don’t have in taste, they may be making up in volume.”
John M. Morton
In a prospective study, Morton and colleagues enrolled 55 patients consecutively undergoing bariatric surgery (mean age, 49.2 years; 69.1% female; 49.1%, white; mean preoperative BMI, 45.3 kg/m2) and 33 healthy participants without obesity as controls.
To quantify the ability to identify lingual tastes including sweet, sour, bitter, salty and umami, patients (preoperatively) and controls completed baseline validated taste tests; paper strips with variable concentrations taste solutions were presented in random order.
“We asked them which ones they were tasting and how strong they perceived the taste to be,” Morton said. “Patients with obesity were more taste insensitive and unable to appreciate taste as much as patients with normal weight.”
Patients who underwent bariatric surgery had lower total taste scores preoperatively compared with both controls and published norms (patients, 13.8; controls, 16.4; norms, 15.7; P<.001).
Patients completed the lingual taste test again at 3, 6 and 12 months after surgery, along with a validated qualitative questionnaire to determine perceived changes in taste sensitivity. BMI and percent excess weight loss (%EWL) also were gathered. Analysis was performed with GraphPad Prism 6.
After surgery, 87% of patients reported a change in taste, and 42% reported eating less because food did not taste good. Lingual total taste score, sweet score and salty score at 3 months were not associated with significant differences in BMI and %EWL at that time.
Patients who reported a taste intensity decrease after surgery on questionnaire had a higher 3-month %EWL vs. those who reported a taste intensity increase (60.7% decrease vs. 39.5% decrease; P=.025).
Morton said the findings have practical implications for weight loss and highlighted wine tasting, during which people are encouraged to consider the color and take in the smell, as an example.
“You combine all your senses, and that gives you a greater appreciation,” Morton said. “Maybe we can use these same sorts of ideas around food to give patients a better appreciation.”
For more information:
Morton JM. Abstract A1007. Presented at: Obesity Week; Nov. 2-7, 2014; Boston.
Disclosure: Morton reports being a consultant for Covidien and Ethicon, a board/committee member for Vivus and receiving honorarium from all three.
Perspective
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Ranjan Sudan, MD
Taste and smell are important senses that can affect the cravings for and the consumption of certain foods. These are intimately connected in the brain and can significantly impact short-term weight loss and long-term weight regain. More research is needed to definitively understand these effects from behavioral and neurobiological standpoints. We have been studying cravings and consumption of food after gastric bypass; cravings and food consumption research are prime targets for combination with smell and taste research.
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