Homeostatic Appetite and Hedonic Hunger 13 Years After Roux-en-Y Gastric Bypass: Potential Associations and Predictive Value in Determining Long-Term Weight Loss Outcomes.

INTRODUCTION

The interplay between homeostatic and hedonic appetite following Roux-en-Y gastric bypass (RYGB) and their potential relevance in modulating long-term weight loss (WL) outcomes has not been properly explored.

AIM

The main aim of this analysis was to explore the association between homeostatic appetite markers and hedonic hunger 13 years post-RYGB. A secondary aim was to determine the association between homeostatic and hedonic appetite, and % total weight loss (TWL).

METHODS

Hedonic hunger was measured with the Power of Food scale (food available, food present, food tasted and aggregated score). The plasma concentration of gastrointestinal (GI) hormones involved in appetite regulation was measured with validated methods, and subjective appetite ratings (hunger, fullness, desire to eat (DTE), and prospective food consumption (PFC)), with visual analogue scales, both in the fasting and postprandial states.

RESULTS

Forty-five participants (age: 50.7 ± 7.8 years, BMI: 34.8 ± 9.3 kg/m, %TWL: 21.0 ± 17.0) were included. Postprandial GLP-1 was inversely associated with food available score. DTE was positively correlated with food available, while PFC was positively correlated with food available, food present, and aggregated score. After adjusting for covariates, food available together with PFC ratings explained 30% of the variability in %TWL post-RYGB. Hormones were found not to contribute to %TWL.

CONCLUSION

The present analyses suggest that the hedonic and homeostatic appetite control systems are intertwined and are both important in modulating long-term WL outcomes post-RYGB. The measurement of appetite ratings and hedonic hunger might be clinically relevant, both during screening and post-operative follow-up aiming at improving long-term WL outcomes.