Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity

Marta Yanina Pepino, Richard I Stein, J Christopher Eagon, Samuel Klein, Marta Yanina Pepino, Richard I Stein, J Christopher Eagon, Samuel Klein

Abstract

Objective: To test the hypotheses that bariatric surgery-induced weight loss: induces remission of food addiction (FA), and normalizes other eating behaviors associated with FA.

Methods: Forty-four obese subjects (BMI= 48 ± 8 kg/m(2) ) were studied before and after ∼20% weight loss induced by bariatric surgery (25 Roux-en-Y gastric bypass, 11 laparoscopic adjustable gastric banding, and eight sleeve gastrectomy). We assessed: FA (Yale Food Addiction Scale), food cravings (Food Craving Inventory), and restrictive, emotional and external eating behaviors (Dutch Eating Behavior Questionnaire).

Results: FA was identified in 32% of subjects before surgery. Compared with non-FA subjects, those with FA craved foods more frequently, and had higher scores for emotional and external eating behaviors (all P-values <0.01; all Cohen's d >0.8). Surgery-induced weight loss resulted in remission of FA in 93% of FA subjects; no new cases of FA developed after surgery. Surgery-induced weight loss decreased food cravings, and emotional and external eating behaviors in both groups (all P-values < 0.001; all Cohen's d ≥ 0.8). Restrictive eating behavior did not change in non-FA subjects but increased in FA subjects (P < 0.01; Cohen's d>1.1).

Conclusion: Bariatric surgery-induced weight loss induces remission of FA and improves several eating behaviors that are associated with FA.

Conflict of interest statement

Conflict of interest. SK is a shareholder of Aspire Bariatrics, Metro Midwest Biotech and Human Longevity Inc, serves or served as a consultant to Aspire Bariatrics, Takeda Pharmaceuticals, Danone/Yakult, NovoNordisk, Merck, and the Egg Nutrition Council. RS served as a consultant to Aspire Bariatrics and serves as a consultant to USGI Medical.

Copyright © 2014 The Obesity Society.

Figures

Figure 1
Figure 1
Prevalence of food addiction measured by the Yale Food Addiction Scale (YFAS) in 44 obese patients before bariatric surgery and after ~20% surgery-induced weight loss. * Significantly different from before surgery, P

Figure 2

Frequency of general food cravings…

Figure 2

Frequency of general food cravings before and after ~20% bariatric surgically induced weight…

Figure 2
Frequency of general food cravings before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

Figure 3

Frequency of cravings for high…

Figure 3

Frequency of cravings for high fat foods (A), starchy foods (B), sweet foods…

Figure 3
Frequency of cravings for high fat foods (A), starchy foods (B), sweet foods (C), and fast-food fats (D) before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

Figure 4

Restrictive, emotional and external scores…

Figure 4

Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire…

Figure 4
Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire compared to the Dutch Normative Scores before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P
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References
    1. Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, et al. Brain dopamine and obesity. Lancet. 2001;357:354–357. - PubMed
    1. Volkow ND, Wang GJ, Fowler JS, Tomasi D, Baler R. Food and drug reward: overlapping circuits in human obesity and addiction. Curr Top Behav Neurosci. 2012;11:1–24. - PubMed
    1. Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL. Evidence that 'food addiction' is a valid phenotype of obesity. Appetite. 2011;57:711–717. - PubMed
    1. Flint AJ, Gearhardt AN, Corbin WR, Brownell KD, Field AE, Rimm EB. Food-addiction scale measurement in 2 cohorts of middle-aged and older women. Am J Clin Nutr. 2014;99:578–586. - PMC - PubMed
    1. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52:430–436. - PubMed
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Figure 2
Figure 2
Frequency of general food cravings before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

Figure 3

Frequency of cravings for high…

Figure 3

Frequency of cravings for high fat foods (A), starchy foods (B), sweet foods…

Figure 3
Frequency of cravings for high fat foods (A), starchy foods (B), sweet foods (C), and fast-food fats (D) before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

Figure 4

Restrictive, emotional and external scores…

Figure 4

Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire…

Figure 4
Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire compared to the Dutch Normative Scores before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P
Similar articles
Cited by
References
    1. Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, et al. Brain dopamine and obesity. Lancet. 2001;357:354–357. - PubMed
    1. Volkow ND, Wang GJ, Fowler JS, Tomasi D, Baler R. Food and drug reward: overlapping circuits in human obesity and addiction. Curr Top Behav Neurosci. 2012;11:1–24. - PubMed
    1. Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL. Evidence that 'food addiction' is a valid phenotype of obesity. Appetite. 2011;57:711–717. - PubMed
    1. Flint AJ, Gearhardt AN, Corbin WR, Brownell KD, Field AE, Rimm EB. Food-addiction scale measurement in 2 cohorts of middle-aged and older women. Am J Clin Nutr. 2014;99:578–586. - PMC - PubMed
    1. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52:430–436. - PubMed
Show all 40 references
Publication types
MeSH terms
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Figure 3
Figure 3
Frequency of cravings for high fat foods (A), starchy foods (B), sweet foods (C), and fast-food fats (D) before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

Figure 4

Restrictive, emotional and external scores…

Figure 4

Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire…

Figure 4
Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire compared to the Dutch Normative Scores before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P
Similar articles
Cited by
References
    1. Wang GJ, Volkow ND, Logan J, Pappas NR, Wong CT, Zhu W, et al. Brain dopamine and obesity. Lancet. 2001;357:354–357. - PubMed
    1. Volkow ND, Wang GJ, Fowler JS, Tomasi D, Baler R. Food and drug reward: overlapping circuits in human obesity and addiction. Curr Top Behav Neurosci. 2012;11:1–24. - PubMed
    1. Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL. Evidence that 'food addiction' is a valid phenotype of obesity. Appetite. 2011;57:711–717. - PubMed
    1. Flint AJ, Gearhardt AN, Corbin WR, Brownell KD, Field AE, Rimm EB. Food-addiction scale measurement in 2 cohorts of middle-aged and older women. Am J Clin Nutr. 2014;99:578–586. - PMC - PubMed
    1. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52:430–436. - PubMed
Show all 40 references
Publication types
MeSH terms
Related information
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 4
Figure 4
Restrictive, emotional and external scores as measured by the Dutch Eating Behavior Questionnaire compared to the Dutch Normative Scores before and after ~20% bariatric surgically induced weight loss in subjects who met criteria for food addiction (FA; black bars), and subjects who did not meet criteria for food addiction (non-FA; white bars). Data are presented as Mean (±SEM). * Significantly different from non-FA, P

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