Research shows several benefits of bariatric surgery

Research shows several benefits of bariatric surgery

People with severe obesity often reward themselves with food. Recent research shows that dieting is good for changing eating habits and weight. However, bariatric surgery has several advantages.

One reason for severe obesity is that we eat even when we are not hungry. We do this to satisfy other needs. We often want to create a short-lived feeling of happiness by rewarding ourselves. Scientists sometimes call this hedonic hunger.

But we already know that this urge to eat is not good for us, even if it means standing with our heads in the fridge late at night. This remains a problem after we have reduced our body weight, because a hedonic appetite can help regain lost weight.

So how can we best counteract a hedonic appetite? Researchers have investigated the matter.

Diet alone or bariatric surgery

We wanted to see how hedonic hunger and food reward changed in patients on low-energy diets and also whether bariatric surgery made a difference.”

Marthe Isaksen Aukan

She is a PhD student in the Department of Clinical and Molecular Medicine at NTNU. The results have now been published in the specialist journal Obesity. Aukan is first author.

With and without surgery

Obesity is defined as a body mass index (BMI) of over 30. Participants in this study had an average BMI of over 40 before starting the diet and, in some cases, also underwent surgery.

• Einigen Studienteilnehmern gelang es, ihr Körpergewicht allein durch eine mehr als zehnwöchige betreute energiearme Diät zu reduzieren.
• Die andere Gruppe wurde zwei Wochen vor einer bariatrischen Operation auf eine energiearme Diät gesetzt.

Both groups were able to successfully lose weight when given help. The researchers found no difference in weight loss between the two groups after ten weeks. The average weight loss for both groups was 16 percent of their baseline weight.

Both groups also ended up in a state of ketosis. Ketosis is caused by the accumulation of residues in the blood because fat reserves are broken down when the body receives little sugar. Ketosis reduces or prevents an increase in appetite.

However, problems often arise in the post-diet period. Then you need to maintain your weight and break bad habits. So which group did best overall?

Both reduced hedonic eating equally

“Participants' hedonic appetite decreased in the post-diet period, both in those who underwent surgery and in those who did not,” says Aukan. “This form of hunger decreased to about the same extent in both groups,” she says.

Professional help in changing your diet alone seems to reduce some of the food intake that is not due to physiological hunger. This finding gives us important insight into how patients who lose weight manage to maintain their weight.

Aukan notes that it may be necessary for people to seek help for a period of time after weight loss if they make major changes in their eating habits.

Why bariatric surgery?

Given the similar results for both groups, does it even make sense to undergo bariatric surgery? For some, the answer is yes, because hedonic eating is only part of the problem with losing weight and losing weight.

Bariatric surgery offers additional benefits in terms of rewarding food and making the right nutritional choices, explains Aukan.

The patients who only took the dietary route showed little or no change in their reward behavior. This was in contrast to participants who also underwent some form of bariatric surgery. Those who had surgery reduced their cravings for food rewards across all food categories.

"We know that the vast majority of people who lose weight through diet alone are not able to maintain their goal weight for very long. Bariatric surgery is the most effective treatment for obesity and results in greater and longer-lasting weight loss," says Aukan.

Forty-four patients with severe obesity completed the study. The researchers noted the importance of further examining the links between hedonic hunger, food reward and long-term weight loss, with both lifestyle changes and bariatric surgery as part of treatment.

Researchers found large individual differences and noted that bariatric surgery is not for everyone. Promising things are also happening with medical treatments.

“But we need to figure out how the factors are related and how we can use this information to provide the best possible and right treatment for everyone,” says Aukan.

Hedonic hunger

The researchers examined two different outcome variables for what they commonly refer to as hedonic appetite:

• Hedonischer Hunger (Einfluss von Nahrung)

This refers to what we experience when our thoughts, feelings, and desire for food are influenced by signals or signs of palatable food, independent of our physiological energy needs.

• Belohnung (Wirkung von schmackhaftem Essen)

Liking: refers to whether and how intensely you like a certain food (state of consciousness).

Want: Includes the motivation to eat this tasty food (both consciously and unconsciously).

Source:

The Norwegian University of Science and Technology (NTNU)

Reference:

Aukan, MI, et al. (2022) Changes in hedonic hunger and food reward following similar weight loss induced by a very low energy diet or bariatric surgery. Obesity. doi.org/10.1002/oby.23535.

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