title: Effects of laparoscopic sleeve gastrectomy on attentional processing of food-related information: evidence from eye-tracking.
abstract: BACKGROUND
  Weight loss after laparoscopic sleeve gastrectomy (LSG) might be associated partially with changes in reward system functioning and altered appetitive responses to food cues. Food cue processing refers to motivational, affective, and cognitive responses to stimuli that are associated with food. We investigated if food cue processing is altered 6 months after weight loss that is induced by LSG. We expected patients after LSG to show reduced appetitive responses to food cues.
  
  
  METHODS
  In an experimental longitudinal exploratory study, 17 severely obese patients (body mass index [BMI]: 48.3 ± 6.5 kg/m²) were investigated presurgery and 6 months postsurgery. We used eye-tracking to assess attentional biases during free viewing of food versus nonfood cues, assessed pleasantness ratings of food cues, and self-reported food craving.
  
  
  RESULTS
  After LSG, the mean BMI of patients was 36.4 ± 6.0 kg/m², and the percentage of excess weight loss (%EWL) was 46.6% ± 14.0%. Six months after LSG, patients showed an attentional bias toward nonfood cues compared with presurgery, reported lower food craving, and rated presented food stimuli as less pleasant.
  
  
  CONCLUSIONS
  Evidence of altered food cue processing was found in patients after LSG, which may be interpreted as reduced food reward associated with increased cognitive control. Surgery-induced physiologic, cognitive-motivational, and behavioral changes may lead to a desensitization of the reward system and enhanced cognitive control.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany. Electronic address: katrin.giel@med.uni-tuebingen.de.
authors.forename: Katrin E
authors.initials: KE
authors.lastname: Giel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rieber
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Enck
authors.affiliation: Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Friederich
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Meile
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Teufel
mesh_terms: D000328:Adult; D001066:Appetite; D001288:Attention / Q000502:physiology*; D015992:Body Mass Index; D005260:Female; D005502:Food; D005743:Gastrectomy / Q000379:methods / Q000523:psychology*; D015391:Gastroplasty / Q000379:methods / Q000523:psychology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011594:Psychometrics / Q000379:methods*; D015431:Weight Loss
keywords: Attention; Bariatric surgery; Craving; Eye-tracking; Food; Laparoscopic sleeve gastrectomy; Obesity; Reward; Weight loss