Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity

Authors

  • Marta Yanina Pepino,

    Corresponding author
    1. Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Richard I. Stein,

    1. Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
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  • J. Christopher Eagon,

    1. Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Samuel Klein

    1. Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Funding agencies: This study was supported by the National Institutes of Health (NIH) grants DK 37948, DK 56341 (Nutrition and Obesity Research Center) and AA 020018.

  • Disclosures: SK is a shareholder of Aspire Bariatrics, Metro Midwest Biotech and Human Longevity Inc, serves or served as a consultant to Aspire Bariatrics, Takeda Pharmaceuticals, Danone/Yakult, NovoNordisk, Merck, and the Egg Nutrition Council. RS served as a consultant to Aspire Bariatrics and serves as a consultant to USGI Medical.

Abstract

Objective

To test the hypotheses that bariatric surgery-induced weight loss: [1] induces remission of food addiction (FA), and [2] normalizes other eating behaviors associated with FA.

Methods

Forty-four obese subjects (BMI= 48 ± 8 kg/m2) were studied before and after ∼20% weight loss induced by bariatric surgery (25 Roux-en-Y gastric bypass, 11 laparoscopic adjustable gastric banding, and eight sleeve gastrectomy). We assessed: [1] FA (Yale Food Addiction Scale), [2] food cravings (Food Craving Inventory), and [3] restrictive, emotional and external eating behaviors (Dutch Eating Behavior Questionnaire).

Results

FA was identified in 32% of subjects before surgery. Compared with non-FA subjects, those with FA craved foods more frequently, and had higher scores for emotional and external eating behaviors (all P-values <0.01; all Cohen's d >0.8). Surgery-induced weight loss resulted in remission of FA in 93% of FA subjects; no new cases of FA developed after surgery. Surgery-induced weight loss decreased food cravings, and emotional and external eating behaviors in both groups (all P-values < 0.001; all Cohen's d ≥ 0.8). Restrictive eating behavior did not change in non-FA subjects but increased in FA subjects (P < 0.01; Cohen's d>1.1).

Conclusion

Bariatric surgery-induced weight loss induces remission of FA and improves several eating behaviors that are associated with FA.

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