Taste-related reward is associated with weight loss following bariatric surgery
Kimberly R. Smith, Afroditi Papantoni, Maria G. Veldhuizen, Vidyulata Kamath, Civonnia Harris, Timothy H. Moran, Susan Carnell, Kimberley E. Steele
Kimberly R. Smith, Afroditi Papantoni, Maria G. Veldhuizen, Vidyulata Kamath, Civonnia Harris, Timothy H. Moran, Susan Carnell, Kimberley E. Steele
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Clinical Research and Public Health Gastroenterology Neuroscience

Taste-related reward is associated with weight loss following bariatric surgery

Abstract

BACKGROUND Bariatric surgeries are the most effective treatments for successful and sustained weight loss, but individuals vary in treatment response. Understanding the neurobiological and behavioral mechanisms accounting for this variation could lead to the development of personalized therapeutic approaches and improve treatment outcomes. The primary objectives of this study were to investigate changes in taste preferences and taste-induced brain responses after Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) and to identify potential taste-related predictors of weight loss.METHODS Females, ages 18 to 55, with a body mass index greater than or equal to 35 kg/m2, and approved for bariatric surgery at the Johns Hopkins Center for Bariatric Surgery were recruited for participation. Demographics, anthropometrics, liking ratings, and neural responses to varying concentrations of sucrose plus fat mixtures were assessed before and after surgery via visual analog scales and functional MRI.RESULTS Bariatric surgery produced decreases in liking for sucrose-sweetened mixtures. Greater preference for sucrose-sweetened mixtures before surgery was associated with greater weight loss in RYGB, but not VSG. In the RYGB group only, individuals who showed lower taste-induced activation in the ventral tegmental area (VTA) before surgery and greater changes in taste-induced VTA activation 2 weeks following surgery experienced increased weight loss.CONCLUSION The anatomical and/or metabolic changes associated with RYGB may more effectively “reset” the neural processing of reward stimuli, thereby rescuing the blunted activation in the mesolimbic pathway found in patients with obesity. Further, these findings suggest that RYGB may be particularly effective in patients with a preference for sweet foods.FUNDING NIH K23DK100559 and Dalio Philanthropies.

Authors

Kimberly R. Smith, Afroditi Papantoni, Maria G. Veldhuizen, Vidyulata Kamath, Civonnia Harris, Timothy H. Moran, Susan Carnell, Kimberley E. Steele

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Figure 4

Preoperative activation in the VTA to taste mixtures predicts 6-month weight loss following RYGB.

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Preoperative activation in the VTA to taste mixtures predicts 6-month we...
(A) Maps depicting areas within VTA ROI showing negative correlation between baseline activation to the high-fat (cream, 0% added sucrose), high-sucrose (skim milk, 20% added sucrose), and preoperative preferred mixtures and weight loss at 6 months in RYGB patients. (B–D) Bivariate correlations demonstrating the relationship between preoperative VTA activation in response to the (B) high-fat, (C) high-sucrose, and (D) most preferred preoperative mixtures and 6-month weight loss following bariatric surgery. Activation in the VTA at baseline to these mixtures presented in the scanner correlated with %TWL at 6 months following RYGB (red, n = 19), but not VSG (blue, n = 20). #Significant bivariate correlations.