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Gut-brain mechanisms underlying changes in disordered eating behaviour after bariatric surgery: a review

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Abstract

Bariatric surgery results in long-term weight loss and an improved metabolic phenotype due to changes in the gut-brain axis regulating appetite and glycaemia. Neuroendocrine alterations associated with bariatric surgery may also influence hedonic aspects of eating by inducing changes in taste preferences and central reward reactivity towards palatable food. However, the impact of bariatric surgery on disordered eating behaviours (e.g.: binge eating, loss-of-control eating, emotional eating and ‘addictive eating’), which are commonly present in people with obesity are not well understood. Increasing evidence suggests gut-derived signals, such as appetitive hormones, bile acid profiles, microbiota concentrations and associated neuromodulatory metabolites, can influence pathways in the brain implicated in food intake, including brain areas involved in sensorimotor, reward-motivational, emotional-arousal and executive control components of food intake. As disordered eating prevalence is a key mediator of weight-loss success and patient well-being after bariatric surgery, understanding how changes in the gut-brain axis contribute to disordered eating incidence and severity after bariatric surgery is crucial to better improve treatment outcomes in people with obesity.

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Funding

EGH is supported by a Melbourne Research Scholarship. CJF is supported by a National Health and Medical Research Council Ideas Grant (2001722). RMB is supported by ARC DECRA (DE190101244). PS is supported by a National Health and Medical Research Council Investigator Grant (1178482).

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  1. Priya Sumithran and Robyn M. Brown equally contributed to this work.

Authors and Affiliations

  1. Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Melbourne, Australia

    Eva Guerrero-Hreins & Robyn M. Brown

  2. Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia

    Eva Guerrero-Hreins & Robyn M. Brown

  3. Department of Physiology, Monash University, Clayton, Melbourne, Australia

    Claire J. Foldi, Brian J. Oldfield & Aneta Stefanidis

  4. Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia

    Claire J. Foldi, Brian J. Oldfield & Aneta Stefanidis

  5. Department of Medicine (St Vincent’s), University of Melbourne, Melbourne, Australia

    Priya Sumithran

  6. Department of Endocrinology, Austin Health, Melbourne, Australia

    Priya Sumithran

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  1. Eva Guerrero-Hreins
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EGH, PS, RMB conceived the idea and researched data for the manuscript. EGH wrote the first draft with assistance from PS and RMB. All authors reviewed and edited the manuscript before submission.

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Correspondence to Robyn M. Brown.

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PS reports fees from Novo Nordisk for participation in advisory boards and a lecture unrelated to the submitted work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Guerrero-Hreins, E., Foldi, C.J., Oldfield, B.J. et al. Gut-brain mechanisms underlying changes in disordered eating behaviour after bariatric surgery: a review. Rev Endocr Metab Disord 23, 733–751 (2022). https://doi.org/10.1007/s11154-021-09696-4

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