Weight loss reduces hedonic hunger, bariatric surgery lowers food cravings
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Weight loss reduced hedonic hunger independently of modality, and bariatric surgery resulted in several beneficial changes in food reward and preferences, according to trial data published in Obesity.
“Following sleeve gastrectomy and Roux-en-Y gastric bypass, patients experience decreases in measures of hedonic eating, lower preference for energy dense foods, development of an aversion to sweetness, lower frequency of food cravings and decreased influence of emotions and external food cues on food intake,” Marthe Isaksen Aukan, MD, PhD candidate in the department of clinical and molecular medicine in the Obesity Research Group at the Norwegian University of Science and Technology and the Centre of Obesity and Innovation at the Clinic of Surgery at St. Olav University Hospital, Trondheim, Norway, and colleagues wrote. “However, knowledge on the effect of dietary restriction alone on hedonic hunger is limited, and no studies have compared diet alone with bariatric surgery.”
The DISGAP study was a three-armed prospective nonrandomized controlled trial of 44 participants. A total of 15 participants were scheduled to receive sleeve gastrectomy (mean age, 39.6 years; 79% women), and 14 were scheduled for Roux-en-Y gastric bypass (mean age, 46.7 years; 61% women). Participants initiated a very low-energy diet 2 weeks before surgery and continued for 8 weeks after surgery. Researchers matched these surgery participants by BMI to 15 controls (mean age, 45.5 years; 69% women) by who followed a very low-energy diet for 10 weeks.
Researchers assessed hedonic hunger through the Power of Food Scale and food reward through the Leeds Food Preference Questionnaire before and after the intervention.
At 11 weeks, participants lost an average of 18.3 kg (16%) of their initial body weight. Of this weight, 13.5 kg was fat mass, and there were no significant differences observed among the three groups.
Researchers observed similar hedonic hunger reductions between controls (P = .001), participants who underwent sleeve gastrectomy (P < .001) and participants who underwent Roux-en-Y gastric bypass (P = .003).
Regarding food reward, researchers observed similar reductions among participants who underwent sleeve gastrectomy and those who had Roux-en-Y gastric bypass. Participants who underwent sleeve gastrectomy or Roux-en-Y gastric bypass experienced postprandial reduced explicit liking for high-fat and savory foods (P = .001 for both) and reduced low-fat and savory foods (P < .001). Participants who underwent sleeve gastrectomy experienced postprandial reduced explicit wanting for high-fat and savory foods (P = .001), high-fat and sweet foods (P = .001) and low-fat and sweet foods (P = .007). Participants who underwent Roux-en-Y gastric bypass also experienced postprandial reduced explicit wanting for high-fat and savory (P = .001), low-fat and savory (P < .001), high-fat and sweet (P = .01) and low-fat and sweet foods (P < .001).
Control participants experienced little to no change in food preference with reductions in only high-fat with sweet (P = .002).
“These preliminary findings need to be confirmed and future research should also investigate the long-term impact of both diet-induced weight loss and bariatric surgery on hedonic hunger and food reward and how initial changes in these constructs might modulate long-term weight-loss outcomes,” the researchers wrote.
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