Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Nutrients. 2021 Nov 4;13(11):3943. doi: 10.3390/nu13113943.
Weight regain is a concerning issue in bariatric patients. We previously demonstrated that taste-related reward processing was associated with six-month weight loss outcomes following Roux-en-Y gastric bypass (RYGB) but not vertical sleeve gastrectomy (VSG). Here, we assessed whether these taste factors persisted in predicting weight loss, and weight regain, at one year post-surgery.
Adult women enrolled in a longitudinal study of taste preferences following bariatric surgery completed behavioral and neuroimaging assessments at one year post-surgery.
RYGB produced better weight loss relative to VSG, with weight regain and greater weight loss variability observed from six months to one year post-VSG. Changes in liking for high fat at 2 weeks post-surgery from baseline remained a predictor of weight loss in RYGB, but other predictors did not persist. Average liking ratings rebounded to baseline and higher self-reported food cravings and dietary disinhibition correlated with poorer weight loss at one year post-surgery.
Initial anatomical and metabolic changes resulting from RYGB that reset neural processing of reward stimuli in the mesolimbic pathway appear to be temporary and may be contingent upon post-operative eating behaviors returning to preoperative obesogenic tendencies. Six months post-surgery may be a critical window for implementing interventions to mitigate weight gain.
体重反弹是肥胖患者的一个令人担忧的问题。我们之前的研究表明,味觉相关的奖励处理与 Roux-en-Y 胃旁路术(RYGB)后六个月的体重减轻结果相关,但与垂直袖状胃切除术(VSG)无关。在这里,我们评估了这些味觉因素是否在术后一年持续预测体重减轻和体重反弹。
在一项关于减肥手术后味觉偏好的纵向研究中,成年女性在术后一年完成了行为和神经影像学评估。
RYGB 与 VSG 相比产生了更好的减重效果,但在 VSG 术后六个月到一年期间观察到体重反弹和更大的体重减轻变异性。术后 2 周对高脂肪的喜爱程度从基线开始的变化仍然是 RYGB 减重的预测因素,但其他预测因素没有持续。平均喜好评分回升到基线,更高的自我报告的食物渴望和饮食抑制与术后一年的减重较差相关。
RYGB 引起的初始解剖和代谢变化似乎是暂时的,可能取决于术后饮食行为恢复到术前肥胖倾向。术后六个月可能是实施干预措施以减轻体重增加的关键窗口。