Edinburgh Research Explorer

Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding

Research output: Contribution to journalArticle

  • Samantha Scholtz
  • Alexander D Miras
  • Navpreet Chhina
  • Christina G Prechtl
  • Michelle L Sleeth
  • Norlida M Daud
  • Nurhafzan A Ismail
  • Giuliana Durighel
  • Ahmed R Ahmed
  • Torsten Olbers
  • Royce P Vincent
  • Jamshid Alaghband-Zadeh
  • Mohammad A Ghatei
  • Adam D Waldman
  • Gary S Frost
  • Jimmy D Bell
  • Carel W le Roux
  • Anthony P Goldstone

Related Edinburgh Organisations

Original languageEnglish
Pages (from-to)891-902
Number of pages12
JournalGut
Volume63
Issue number6
DOIs
Publication statusPublished - 20 Aug 2013

Abstract

OBJECTIVES: Roux-en-Y gastric bypass (RYGB) has greater efficacy for weight loss in obese patients than gastric banding (BAND) surgery. We hypothesise that this may result from different effects on food hedonics via physiological changes secondary to distinct gut anatomy manipulations.

DESIGN: We used functional MRI, eating behaviour and hormonal phenotyping to compare body mass index (BMI)-matched unoperated controls and patients after RYGB and BAND surgery for obesity.

RESULTS: Obese patients after RYGB had lower brain-hedonic responses to food than patients after BAND surgery. RYGB patients had lower activation than BAND patients in brain reward systems, particularly to high-calorie foods, including the orbitofrontal cortex, amygdala, caudate nucleus, nucleus accumbens and hippocampus. This was associated with lower palatability and appeal of high-calorie foods and healthier eating behaviour, including less fat intake, in RYGB compared with BAND patients and/or BMI-matched unoperated controls. These differences were not explicable by differences in hunger or psychological traits between the surgical groups, but anorexigenic plasma gut hormones (GLP-1 and PYY), plasma bile acids and symptoms of dumping syndrome were increased in RYGB patients.

CONCLUSIONS: The identification of these differences in food hedonic responses as a result of altered gut anatomy/physiology provides a novel explanation for the more favourable long-term weight loss seen after RYGB than after BAND surgery, highlighting the importance of the gut-brain axis in the control of reward-based eating behaviour.

    Research areas

  • Adult, Appetite Regulation, Bile Acids and Salts, Body Mass Index, Brain, Diet Records, Dumping Syndrome, Feeding Behavior, Female, Food, Gastric Bypass, Gastroplasty, Glucagon-Like Peptide 1, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Obesity, Peptide YY, Pleasure, Young Adult, Journal Article, Research Support, Non-U.S. Gov't

ID: 46126805