Prospective Study of Appetitive Sensations after Metabolic and Bariatric Surgery Compared with Low-Calorie Diet

Metabolic and bariatric surgery (MBS) causes greater weight loss (WL) compared with low-calorie diet (LCD) that may be due to changes in appetite and gut hormones. The objective of this study was to quantify appetitive sensations in individuals who underwent LCD or MBS at equivalent weight loss (T2) and at one year (T3).

Visual analog scales (VAS) and the food craving inventory were used to assess appetite. Glucagon-like peptid-1 (GLP-1) levels were quantified by ELISA.

Participants available for both T1 and T2 were as follows: LCD (n = 15), surgery (n = 24). By T3, LCD (n = 12) and surgery (n = 15). At T2, percent total WL (%TWL) was similar between LCD vs surgery (14.9% vs 14.6%; p = 0.94). At T3, there was greater %TWL after surgery compared with LCD (30.2% vs 14.6%; p < 0.0001). At T2, there was a significant increase in postprandial fullness and decreases in hunger and prospective eating only after surgery. Cravings decreased in both groups at T2 but remained decreased at T3 only after surgery. There was almost a two-fold increase from T1 to T2 in postprandial GLP-1 after surgery (p < 0.0001) that correlated with the increase in fullness (r = 0.69; p = 0.038); no change was noted after LCD (p = 0.34).

After equivalent WL, MBS results in favorable changes in appetitive sensations and GLP-1 levels compared with LCD. Such changes may support the ability to achieve greater reduction in body weight after MBS.