title: Reported appetite, taste and smell changes following Roux-en-Y gastric bypass and sleeve gastrectomy: Effect of gender, type 2 diabetes and relationship to post-operative weight loss.
abstract: Reduced energy intake drives weight loss following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures. Post-operative changes in subjective appetite, taste, and smell and food preferences are reported and suggested to contribute to reduced energy intake. We aimed to investigate the prevalence of these changes following RYGB and SG and to evaluate their relationship with weight loss. 98 patients post-RYGB and 155 post-SG from a single bariatric centre were recruited to a cross-sectional study. Participants completed a questionnaire, previously utilised in post-operative bariatric patients, to assess the prevalence of post-operative food aversions and subjective changes in appetite, taste and smell. Anthropometric data were collected and percentage weight loss (%WL) was calculated. The relationship between food aversions, changes in appetite, taste and smell and %WL was assessed. The influence of time post-surgery, gender and type 2 diabetes (T2D) were evaluated. Following RYGB and SG the majority of patients reported food aversions (RYGB = 62%, SG = 59%), appetite changes (RYGB = 91%, SG = 91%) and taste changes (RYGB = 64%, SG = 59%). Smell changes were more common post-RYGB than post-SG (RYGB = 41%, SG = 28%, p = 0.039). No temporal effect was observed post-RYGB. In contrast, the prevalence of appetite changes decreased significantly with time following SG. Post-operative appetite changes associated with and predicted higher %WL post-SG but not post-RYGB. Taste changes associated with and predicted higher %WL following RYGB but not post-SG. There was no gender effect post-RYGB. Post-SG taste changes were less common in males (female = 65%, males = 40%, p = 0.008). T2D status in females did not influence post-operative subjective changes. However, in males with T2D, taste changes were less common post-SG than post-RYGB together with lower %WL (RYGB = 27.5 ± 2.7, SG = 14.6 ± 2.1, p = 0.003). Further research is warranted to define the biology underlying these differences and to individualise treatments.
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom; National Institute of Health Research, University College London Hospital Biomedical Research Centre, London W1T 7DN, United Kingdom.
authors.forename: Janine M
authors.initials: JM
authors.lastname: Makaronidis
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Neilson
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Wui-Hang
authors.initials: WH
authors.lastname: Cheung
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom.
authors.forename: Urszula
authors.initials: U
authors.lastname: Tymoszuk
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pucci
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Finer
authors.affiliation: University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Doyle
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Majid
authors.initials: M
authors.lastname: Hashemi
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom; Clinical and Experimental Surgery Department, Medical Research Institute, University of Alexandria, Hadara, Alexandria 21561, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elkalaawy
authors.affiliation: University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Marco
authors.initials: M
authors.lastname: Adamo
authors.affiliation: University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jenkinson
authors.affiliation: Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London WC1E 6JF, United Kingdom; University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, Ground Floor West Wing, 250 Euston Road, London NW1 2PG, United Kingdom; National Institute of Health Research, University College London Hospital Biomedical Research Centre, London W1T 7DN, United Kingdom. Electronic address: r.batterham@ucl.ac.uk.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Batterham
mesh_terms: D000328:Adult; D001066:Appetite; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005518:Food Preferences; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012737:Sex Factors; D012903:Smell; D011795:Surveys and Questionnaires; D013649:Taste; D015431:Weight Loss
keywords: Appetite; Food aversions; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy; Smell; Taste; Weight loss