title: Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding.
abstract: OBJECTIVE
  Roux-en-Y gastric bypass (RYGB) has greater efficacy for weight loss in obese patients than gastric banding (BAND) surgery. We hypothesise that this may result from different effects on food hedonics via physiological changes secondary to distinct gut anatomy manipulations.
  
  
  METHODS
  We used functional MRI, eating behaviour and hormonal phenotyping to compare body mass index (BMI)-matched unoperated controls and patients after RYGB and BAND surgery for obesity.
  
  
  RESULTS
  Obese patients after RYGB had lower brain-hedonic responses to food than patients after BAND surgery. RYGB patients had lower activation than BAND patients in brain reward systems, particularly to high-calorie foods, including the orbitofrontal cortex, amygdala, caudate nucleus, nucleus accumbens and hippocampus. This was associated with lower palatability and appeal of high-calorie foods and healthier eating behaviour, including less fat intake, in RYGB compared with BAND patients and/or BMI-matched unoperated controls. These differences were not explicable by differences in hunger or psychological traits between the surgical groups, but anorexigenic plasma gut hormones (GLP-1 and PYY), plasma bile acids and symptoms of dumping syndrome were increased in RYGB patients.
  
  
  CONCLUSIONS
  The identification of these differences in food hedonic responses as a result of altered gut anatomy/physiology provides a novel explanation for the more favourable long-term weight loss seen after RYGB than after BAND surgery, highlighting the importance of the gut-brain axis in the control of reward-based eating behaviour.
authors: Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, , London, UK.
authors: Samantha
authors: S
authors: Scholtz
authors: Alexander D
authors: AD
authors: Miras
authors: Navpreet
authors: N
authors: Chhina
authors: Christina G
authors: CG
authors: Prechtl
authors: Michelle L
authors: ML
authors: Sleeth
authors: Norlida M
authors: NM
authors: Daud
authors: Nurhafzan A
authors: NA
authors: Ismail
authors: Giuliana
authors: G
authors: Durighel
authors: Ahmed R
authors: AR
authors: Ahmed
authors: Torsten
authors: T
authors: Olbers
authors: Royce P
authors: RP
authors: Vincent
authors: Jamshid
authors: J
authors: Alaghband-Zadeh
authors: Mohammad A
authors: MA
authors: Ghatei
authors: Adam D
authors: AD
authors: Waldman
authors: Gary S
authors: GS
authors: Frost
authors: Jimmy D
authors: JD
authors: Bell
authors: Carel W
authors: CW
authors: le Roux
authors: Anthony P
authors: AP
authors: Goldstone
mesh_terms: D000328:Adult; D001069:Appetite Regulation; D001647:Bile Acids and Salts / Q000097:blood; D015992:Body Mass Index; D001921:Brain / Q000503:physiopathology*; D015930:Diet Records; D004377:Dumping Syndrome / Q000209:etiology; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology*; D005260:Female; D005502:Food; D015390:Gastric Bypass / Q000009:adverse effects / Q000523:psychology; D015391:Gastroplasty / Q000009:adverse effects / Q000523:psychology; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D019894:Peptide YY / Q000097:blood; D057181:Pleasure; D055815:Young Adult
chemical_list: D001647:Bile Acids and Salts; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1
keywords: Bile Acid; Brain Imaging; Brain/Gut Interaction; Gastrointestinal Hormones; Obesity Surgery
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