• Relationships among tonic and episodic aspects of motivation to eat, gut peptides, and weight before and after bariatric surgery.

      Bryant, Eleanor J.; King, N.; Falken, Y.; Hellstrom, P.; Holst, J.J.; Blundell, J.E.; Naslund, E. (18/09/2013)
      Background The interaction between motivation to eat, eating behaviour traits and gut peptides following gastric bypass (GBP) surgery are not fully understood. Setting Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. Method Appetite and hormone responses to a fixed liquid pre-load were assessed in 12 obese (BMI 45 ± 1.9 kg/m2) participants immediately before, 3 days, 2 months, and 1 year following gastric by-pass (GBP) surgery. Subjective appetite and plasma levels of ghrelin, leptin, insulin and GLP-1 were measured for a 3-hour postprandial period. Eating behaviour traits were also measured using the TFEQR18. Results There was a decrease in TFEQ Emotional Eating (EE) and Uncontrolled Eating (UE) from pre to 1-year post-surgery, but no significant change in Restraint. In addition, there was a reduction in subjective appetite ratings, and alterations in appetite peptides favouring an anorectic response. Pre-surgery EE was significantly related to fasting and AUC ghrelin; UE was associated with AUC desire to eat while there was a significant association between fasting desire to eat and ghrelin (fasting and AUC). 1 year post-surgery, UE was positively related to fasting insulin and Restraint was negatively associated with GLP-1. UE and subjective hunger were positively correlated, while the relationship between desire to eat and ghrelin remained. Conclusion The relationships amongst subjective appetite ratings, eating behaviour traits and appetite peptides in obese patients both before and at one-year post GBP surgery contribute to the reduction in a propensity to over-eat and weight loss.