Obesity Surgery

, Volume 23, Issue 1, pp 50–55 | Cite as

Roux-en Y Gastric Bypass Surgery Reduces Hedonic Hunger and Improves Dietary Habits in Severely Obese Subjects

  • Jennifer Ullrich
  • Barbara Ernst
  • Britta Wilms
  • Martin Thurnheer
  • Bernd SchultesEmail author
Clinical Research



Many obese subjects suffer from an increased hedonic drive to consume palatable foods, i.e., hedonic hunger, and often show unfavorable dietary habits. Here, we investigated changes in the hedonic hunger and dietary habits after Roux-en-Y gastric bypass (RYGB) surgery.


Forty-four severely obese patients were examined before and on average 15.9 ± 0.9 months after RYGB surgery with the Power of Food Scale (PFS), a questionnaire that reliably measures an individual’s motivation to consume highly palatable foods but not actual consumptive behavior. Dietary habits were assessed by a food frequency questionnaire.


After the RYGB procedure, patients showed markedly lower aggregated PFS scores and sub-domain scores related to generally available, physically present, as well as tasted foods than before the surgery (all P < 0.001). Changes in dietary habits after the surgery were characterized by a more frequent consumption of poultry, fish, eggs, and cooked vegetables (P < 0.008) and a less frequent consumption of chocolate (P < 0.048), cakes/biscuits/cookies (P = 0.09), and fruit juice/soft drinks (P = 0.08).


Data show a marked reduction of the hedonic drive to consume palatable food and beneficial changes in dietary habits characterized by an increased intake of protein-rich foods and vegetables and a reduced consumption of sugar-containing snacks and beverages after RYGB surgery. Based on these findings, it can be speculated that the reduction of the hedonic drive to consume palatable foods induced by RYGB surgery helps severely obese patients to establish healthier dietary habits.


Eating behavior Food consumption Hedonic drive Protein-rich foods Bariatric surgery 



We gratefully thank Dr. Michael Lowe from the Department of Psychology, Drexel University, Philadelphia, for generously providing us with the Power of Food Scale and all of our patients who filled in the questionnaires.

Conflict of Interest

All contributing authors declare that they have no conflicts of interest.

Sources of Funding

The study was financed by intramural financial resources of the Interdisciplinary Obesity Center, Kantonsspital St. Gallen.


  1. 1.
    Lowe MR, Butryn ML. Hedonic hunger: a new dimension of appetite? Physiol Behav. 2007;91:432–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Schultes B, Ernst B, Wilms B, et al. Hedonic hunger is increased in severely obese patients and is reduced after gastric bypass surgery. Am J Clin Nutr. 2010;92:277–83.PubMedCrossRefGoogle Scholar
  3. 3.
    Ernst B, Thurnheer M, Wilms B, et al. Differential changes in dietary habits after gastric bypass versus gastric banding operations. Obes Surg. 2009;19:274–80.PubMedCrossRefGoogle Scholar
  4. 4.
    Cappelleri JC, Bushmakin AG, Gerber RA, et al. Evaluating the Power of Food Scale in obese subjects and a general sample of individuals: development and measurement properties. Int J Obes. 2009;33:913–22.CrossRefGoogle Scholar
  5. 5.
    Lowe MR, Butryn ML, Didie ER, et al. The Power of Food Scale. A new measure of the psychological influence of the food environment. Appetite. 2009;53:114–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines on surgery of severe obesity. Obes Facts. 2008;1:52–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47:1102–14.PubMedCrossRefGoogle Scholar
  9. 9.
    Ashrafian H, le Roux CW. Metabolic surgery and gut hormones—a review of bariatric entero-humoral modulation. Physiol Behav. 2009;97:620–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Kral JG, Naslund E. Surgical treatment of obesity. Nat Clin Pract Endocrinol Metab. 2007;3:574–83.PubMedCrossRefGoogle Scholar
  11. 11.
    Konner AC, Klockener T, Bruning JC. Control of energy homeostasis by insulin and leptin: targeting the arcuate nucleus and beyond. Physiol Behav. 2009;97:632–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Shin AC, Zheng H, Berthoud HR. An expanded view of energy homeostasis: neural integration of metabolic, cognitive, and emotional drives to eat. Physiol Behav. 2009;97:572–80.PubMedCrossRefGoogle Scholar
  13. 13.
    Batterham RL, Fytche DH, Rosenthal JM, et al. PYY modulation of cortical and hypothalamic brain areas predicts feeding behaviour in humans. Nature. 2007;450:106–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Ochner CN, Kwok Y, Conceicao E, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg. 2011;253:502–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2012

Authors and Affiliations

  • Jennifer Ullrich
    • 1
  • Barbara Ernst
    • 1
  • Britta Wilms
    • 1
  • Martin Thurnheer
    • 1
  • Bernd Schultes
    • 1
    • 2
    Email author
  1. 1.Interdisciplinary Obesity CenterKantonsspital St. GallenRorschachSwitzerland
  2. 2.Oberwaid, Kurhaus & Medical CenterSt. GallenSwitzerland

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