Objective The aim of this study was to compare changes in gastrointestinal hormones and appetite ratings after a similar weight loss induced by a very low‐energy diet alone or in combination with sleeve gastrectomy (SG) or Roux‐en‐Y gastric bypass (RYGB). Methods Patients with severe obesity scheduled for SG (n = 15) and RYGB (n = 14) and 15 controls (very low‐energy diet alone) were recruited. Body weight/composition, plasma concentrations of ß‐hydroxybutyric acid, acylated ghrelin, total glucagon‐like peptide‐1, total peptide YY, cholecystokinin, and ratings of hunger, fullness, desire to eat, and prospective food consumption were measured pre‐ and postprandially, before and after 10 weeks of intervention. Results Changes in body weight/composition and level of ketosis were similar across groups. In SG and RYGB, basal and postprandial acylated ghrelin declined, and postprandial glucagon‐like peptide‐1 increased, both significantly more compared with controls. Postprandial peptide YY increased in all groups. Overall, postprandial hunger decreased, and postprandial fullness increased. But ratings of desire to eat and prospective food consumption were more favorable after both surgeries compared with controls. Conclusions Weight loss with SG and RYGB leads to more favorable changes in gastrointestinal hormones compared with diet alone, although ratings of appetite were reduced across all groups.

Objective The aim of this study was to compare changes in hedonic hunger and food reward in individuals with severe obesity achieving 10% to 15% weight loss with a very low‐energy diet (VLED) alone or VLED and bariatric surgery. Methods Patients scheduled for sleeve gastrectomy (SG) or Roux‐en‐Y gastric bypass (RYGB) initiated a VLED 2 weeks prior to surgery and continued the diet for 8 weeks postoperatively. BMI‐matched controls underwent a VLED for 10 weeks. Hedonic hunger was assessed with the Power of Food Scale, and food reward with the Leeds Food Preference Questionnaire, pre and post intervention. Results A total of 44 participants completed the study: 15 SG, 14 RYGB, and 15 controls (61%, 79% and 69% females, respectively; BMI: 40.5 ± 0.5 kg/m2; age: 43.9 ± 1.4 years). Average weight loss was 18.3 ± 0.6 kg (16%), comprising 13.5 ± 0.5 kg fat mass, with no significant differences between groups. Similar reductions in hedonic hunger were observed in all groups. Overall, food reward was similarly reduced in SG and RYGB groups, whereas controls showed little or no change. Conclusions Independent of modality, weight loss seems to reduce hedonic hunger, but bariatric surgery leads to several additional favorable changes in food reward and preferences.