Introduction: Studies suggest that weight loss induced by bariatric surgery and the
remission of some comorbidities may be related to changes in the microbiota
profile of individuals undergoing this procedure. In addition, there is
evidence that manipulation of the intestinal microbiota may prove to be a
therapeutic approach against obesity and metabolic diseases. Objective: To verify the changes that occur in the intestinal microbiota of patients
undergoing bariatric surgery, and the impact of the usage of probiotics in
this population. Methods: Articles published between 2007 and 2017 were searched in Medline, Lilacs and
Pubmed with the headings: bariatric surgery, microbiota, microbiome and
probiotics, in Portuguese, English and Spanish. Of the 166 articles found,
only those studies in adults subjected to either Roux-en-Y gastric bypass or
sleeve vertical gastrectomy published in original articles were enrolled. In
the end, five studies on the change of intestinal microbiota composition,
four on the indirect effects of those changes and three on the probiotics
administration on this population were enrolled and characterized. Conclusion: Bariatric surgery provides changes in intestinal microbiota, with a relative
increase of the Bacteroidetes and Proteobacteria phyla and reduction of
Firmicutes. This is possibly due to changes in the gastro-intestinal flux,
coupled with a reduction in acidity, in addition to changes in eating
habits. The usage of probiotics seems to reduce the gastro-intestinal
symptoms in the post-surgery, favor the increase of vitamin B12 synthesis,
as well as potentiate weight loss.
BACKGROUND: The use of probiotics as adjuvants in the treatment of eating disorders, known as psychobiotics, has already been investigated as a means of modulating the microbiota-gut-brain axis. AIM: This study aimed to assess the effect of probiotic supplementation on binge eating and food addiction in subjects after Roux-en-Y gastric bypass surgery. METHODS: This is a randomized, double-blind, placebo-controlled trial involving 101 patients who received probiotic (Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07) or placebo supplements for 90 days after bariatric surgery, starting on the seventh postoperative day. They were evaluated preoperatively (T0) and postoperatively at 90 days (T1) and 1 year (T2) after surgery. The Yale Food Addiction Scale (YFAS) and Binge Eating Scale (BES) were applied to assess food addiction and binge eating, respectively. RESULTS: Before surgery, one-third of the patients presented with a food addiction and binge eating diagnosis. The number of symptoms of YFAS and the BES score decreased significantly in both groups at T1 compared to T0. However, a significant effect of treatment with probiotics was observed 1 year after surgery (T2). Both the number of symptoms of food addiction and the binge eating score were lower in the probiotic group than in the placebo group (p=0.037 and p=0.030, respectively). CONCLUSION: The use of probiotic supplementation for 90 days in the immediate postoperative period may decrease food addiction symptoms and binge eating score up to 1 year after surgery compared to controls.
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