Behary Preeshila, Miras Alexander D
Division of Diabetes, Endocrinology and Metabolism,Hammersmith Hospital,Imperial College London,Du Cane Road,London,UK.
Proc Nutr Soc. 2015 Nov;74(4):419-25. doi: 10.1017/S0029665115002074. Epub 2015 May 20.
Bariatric surgery leads to significant long-term weight loss, particularly Roux-en-Y gastric bypass (RYGB). The mechanisms underlying weight loss have not been fully uncovered. The aim of this review is to explore the changes in food preferences, as a novel mechanism contributing to weight loss, and also focus on the underlying processes modulating eating behaviour after bariatric surgery. Patients after gastric bypass are less hungry and prefer healthier food options. They develop an increased acuity to sweet taste, which is perceived as more intense. The appeal of sweet fatty food decreases, with functional MRI studies showing a corresponding reduction in activation of the brain reward centres to high-energy food cues. Patients experiencing post-ingestive symptoms with sweet and fatty food develop conditioned aversive behaviours towards the triggers. Gut hormones are elevated in RYGB and have the potential to influence the taste system and food hedonics. Current evidence supports a beneficial switch in food preferences after RYGB. Changes within the sensory and reward domain of taste and the development of post-ingestive symptoms appear to be implicated. Gut hormones may be the mediators of these alterations and therefore exploiting this property might prove beneficial for designing future obesity treatment.
减肥手术可带来显著的长期体重减轻,尤其是 Roux-en-Y 胃旁路术(RYGB)。体重减轻的潜在机制尚未完全明确。本综述的目的是探讨食物偏好的变化,这是一种导致体重减轻的新机制,同时关注减肥手术后调节饮食行为的潜在过程。胃旁路术后的患者饥饿感降低,更喜欢健康的食物选择。他们对甜味的敏感度增加,感觉甜味更强烈。甜腻食物的吸引力下降,功能磁共振成像研究表明,大脑奖赏中枢对高能食物线索的激活相应减少。食用甜腻食物后出现消化后症状的患者会对引发症状的食物产生条件性厌恶行为。RYGB 术后肠道激素水平升高,有可能影响味觉系统和食物享乐主义。目前的证据支持 RYGB 术后食物偏好的有益转变。味觉的感官和奖赏领域内的变化以及消化后症状的出现似乎与之有关。肠道激素可能是这些改变的介导因素,因此利用这一特性可能有助于设计未来的肥胖治疗方案。