Roux-en-Y gastric bypass: effects on feeding behavior and underlying mechanisms

Manning, Sean; Pucci, Andrea; Batterham, Rachel L.

doi:10.1172/jci76305

Cited by 79 publications

(63 citation statements)

References 134 publications

(145 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To conclude, we established in a European, severely obese population significant sex-specific differences in eating behaviors and differences in rare functional mutations of the MC4R gene associated with 6-year outcomes of mechanistically different gastrointestinal bariatric operations consistent with current understanding (46). Careful preoperative studies of eating behavior and MC4R screening to identify aggressive overeaters may achieve substantial improvements in outcomes of bariatric operations by selective allocation to bypass or banding.…”

Section: Discussionmentioning

confidence: 76%

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study

et al. 2016

View full text Add to dashboard Cite

OBJECTIVEData on the effects of eating behavior and genetics on outcomes of gastrointestinal surgery for diabesity have been sparse, often flawed, and controversial. We aimed to assess long-term outcomes of bariatric operations in patients characterized for eating behavior and rare mutations in the melanocortin-4 receptor (MC4R) gene, which is strongly implicated in energy balance. RESEARCH DESIGN AND METHODSBetween 1996 and 2005, 1,264 severely obese Swiss patients underwent current laparoscopic adjustable gastric banding, gastroduodenal bypass, or a hybrid operation. Of these, 872 patients were followed for a minimum of 6 years and were screened for MC4R mutations. Using regression models, we studied relationships between eating behavior and MC4R mutations and postoperative weight loss, complications, and reoperations after 6 years. RESULTSAt baseline, rare functional MC4R mutation carriers exhibited a significantly higher prevalence of binge eating disorder (BED) or loss-of-control eating independent of age, sex, and BMI. Six years after bariatric surgery, the mutation carriers had more major complications than wild-type subjects independent of age, baseline BMI, sex, operation type, and weight loss. Furthermore, high baseline BMI, male sex, BED, and functional MC4R mutations were independent predictors of higher reoperation rates. CONCLUSIONSSequencing of MC4R and eating typology, combined with stratification for sex and baseline BMI, might significantly improve patient allocation to banding or bypass operations for diabesity as well as reduce both complication and reoperation rates.

show abstract

Section: Discussionmentioning

confidence: 76%

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…However, following bariatric surgery, these individuals often decrease the intake of calorically dense foods, have altered taste acuity and altered food preferences [68,71,72,77,85], [124], [125] 2015, [126][127][128][129]. Several studies have investigated differences in taste perception and food preferences between different forms of bariatric surgery, (e.g.…”

Section: Taste and Bariatric Surgery In Clinical Populationsmentioning

confidence: 99%

Recent advances in the modification of taste and food preferences following bariatric surgery

Primeaux

Silva

Tzeng

et al. 2016

Rev Endocr Metab Disord

View full text Add to dashboard Cite

There is a large body of evidence indicating that bariatric surgery provides durable weight loss and health benefits to patients who are obese and have comorbidities such as type 2 diabetes (T2D). However, there are still many questions related to mechanisms of metabolic improvement, predictors of success/failure, and long term consequences, which need to be answered. More recently, there has been a particular interest in the modulation of taste and food preferences that occurs after bariatric surgery and how this affects weight loss in different individuals. Animal models as well as human studies have shed some light on the role of taste in changing food preferences and how these changes may affect weight loss after surgery. The goal of this review is to discuss the physiological and behavioral consequences of bariatric surgery as a treatment for obesity and T2D, with particular emphasis on recent studies describing bariatric surgery-induced modifications in taste perception and food preferences.

show abstract

“…The most successful, as well as most invasive, therapy for weight loss is bariatric bypass surgery (16). A recent review summarized the hormonal, neuronal, and metabolic consequences of bariatric surgery and emphasized that the interplay of these factors leads to changes in feeding behavior (17). Longterm follow-up studies on weight development after bariatric surgery showed an excess weight loss of .50% and, in some cases, .70% after 10 years (18).…”

mentioning

confidence: 99%

Neuronal Food Reward Activity in Patients With Type 2 Diabetes With Improved Glycemic Control After Bariatric Surgery

et al. 2016

View full text Add to dashboard Cite

OBJECTIVEObesity and type 2 diabetes mellitus (T2DM) are associated with altered foodrelated neuronal functions. Besides weight loss, substantial improvement of glucose metabolism in patients with T2DM can be achieved by bariatric surgery. We aimed to target the neuronal and behavioral correlates of improved glycemic control after bariatric surgery. RESEARCH DESIGN AND METHODSTwo patient groups with T2DM were recruited. The treatment group (n = 12) consisted of patients who had undergone Roux-en-Y gastric bypass (RYGB) surgery, and a control group consisted of patients who did not undergo surgery (n = 12). The groups were matched for age and current BMI. HbA 1c was matched by using the presurgical HbA 1c of the RYGB group and the current HbA 1c of the nonsurgical group. Neuronal activation during a food reward task was measured using functional MRI (fMRI). Behavioral data were assessed through questionnaires. RESULTSRYGB improved HbA 1c from 7.07 6 0.50 to 5.70 6 0.16% (P < 0.05) and BMI from 52.21 6 1.90 to 35.71 6 0.84 kg/m 2 (P < 0.001). Behavioral results showed lower wanting and liking scores as well as lower eating behavior-related pathologies for the patients after RYGB than for similar obese subjects without surgery but with impaired glycemic control. The fMRI analysis showed higher activation for the nonsurgical group in areas associated with inhibition and reward as well as in the precuneus, a major connectivity hub in the brain. By contrast, patients after RYGB showed higher activation in the visual, motor, cognitive control, memory, and gustatory regions. CONCLUSIONSIn obese patients with diabetes, RYGB normalizes glycemic control and leads to food reward-related brain activation patterns that are different from those of obese patients with less-well-controlled T2DM and without bariatric surgery. The differences in food reward processing might be one factor in determining the outcome of bariatric surgery in patients with T2DM.

show abstract

Roux-en-Y gastric bypass: effects on feeding behavior and underlying mechanisms

Cited by 79 publications

References 134 publications

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study

Recent advances in the modification of taste and food preferences following bariatric surgery

Neuronal Food Reward Activity in Patients With Type 2 Diabetes With Improved Glycemic Control After Bariatric Surgery

Contact Info

Product

Resources

About