Purpose of Review
The purpose of this literature review is to explore a potentially controversial hypothesis– that bariatric surgery could be used as a “treatment” for food addiction.
Two small studies have examined food addiction pre- and post-bariatric surgery and suggest that the prevalence of symptoms is reduced within the first-year post-operatively. Many physiological, metabolic, and neurobiological changes occur following bariatric surgery. Theoretically, these changes that modify the factors associated with obesity and eating behaviors related to obesity could also impact food addiction symptoms.
Future research includes need for examination of whether bariatric surgery improves or worsens food addiction symptoms, especially over the long term. Although the title of this review is bold, in practice, it would behoove providers to carefully evaluate patients pre- and post-operatively to determine best treatment approaches for those with food addiction and severe obesity.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Gearhardt AN, Corbin WR, Brownell KD. Food addiction: an examination of the diagnostic criteria for dependence. J Addict Med. 2009;3(1):1–7.
Association AP, editor. The diagnostic and statistical manual of mental disorders (DSM-5). Arlington, VA2013.
Schulte EM, Gearhardt AN. Development of the modified Yale food addiction scale version 2.0. Eur Eat Disord Rev. 2017;25(4):302–8.
Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond Ser B Biol Sci. 2008;363(1507):3191–200.
Lindgren E, Gray K, Miller G, Tyler R, Wiers CE, Volkow ND, et al. Food addiction: a common neurobiological mechanism with drug abuse. Front Biosci (Landmark Ed). 2018;23:811–36.
Hebebrand J, Albayrak O, Adan R, Antel J, Dieguez C, de Jong J, et al. “Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior. Neurosci Biobehav Rev. 2014;47:295–306.
Ruddock HK, Christiansen P, Halford JCG, Hardman CA. The development and validation of the addiction-like eating behaviour scale. Int J Obes. 2017;41(11):1710–7.
Meule A. A critical examination of the practical implications derived from the food addiction concept. Curr Obes Rep. 2019;8(1):11–7.
Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale food addiction scale. Appetite. 2009;52(2):430–6.
Gearhardt AN, Corbin WR, Brownell KD. Development of the Yale food addiction scale version 2.0. Psychol Addict Behav. 2016;30(1):113–21.
Meule AG. A. Ten years of the Yale food addiction scale: a Review of Version 2.0. Current Addiction Reports. 2019;6(3):218–28.
Finlayson G. Food addiction and obesity: unnecessary medicalization of hedonic overeating. Nat Rev Endocrinol. 2017;13(8):493–8.
Mitchell JE, King WC, Courcoulas A, Dakin G, Elder K, Engel S, et al. Eating behavior and eating disorders in adults before bariatric surgery. Int J Eat Disord. 2015;48(2):215–22.
Mitchell JE, Selzer F, Kalarchian MA, Devlin MJ, Strain GW, Elder KA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8(5):533–41.
Fairburn CG, Cooper, Z., O’Connor, M.. The eating disorder examination (Edition 17.0) [Available from: https://www.credo-oxford.com/pdfs/EDE_17.0D.pdf.
Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity (Silver Spring). 2008;16(3):615–22.
Goodpaster KPS, Marek RJ, Lavery ME, Ashton K, Merrell Rish J, Heinberg LJ. Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates. Surg Obes Relat Dis. 2016;12(5):1091–7.
Conceicao EM, de Lourdes M, Pinto-Bastos A, Vaz AR, Brandao I, Ramalho S. Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: the mediating role of loss of control eating. Int J Eat Disord. 2018;51(6):507–17.
Brode CS, Mitchell JE. Problematic eating behaviors and eating disorders associated with bariatric surgery. Psychiatr Clin North Am. 2019;42(2):287–97.
Goldschmidt AB, Conceicao EM, Thomas JG, Mitchell JE, Raynor HA, Bond DS. Conceptualizing and studying binge and loss of control eating in bariatric surgery patients-time for a paradigm shift? Surg Obes Relat Dis. 2016;12(8):1622–5.
Ivezaj V, Wiedemann AA, Lawson JL, Grilo CM. Food addiction in sleeve gastrectomy patients with loss-of-control eating. Obes Surg. 2019.
Schulte EM, Grilo CM, Gearhardt AN. Shared and unique mechanisms underlying binge eating disorder and addictive disorders. Clin Psychol Rev. 2016;44:125–39.
Ivezaj V, Wiedemann AA, Grilo CM. Overvaluation of weight or shape and loss-of-control eating following bariatric surgery. Obesity (Silver Spring). 2019;27(8):1239–43.
Lydecker JA, Cunningham PM, O’Brien E, Grilo CM. Parents’ perceptions of parent-child interactions related to eating and body image: an experimental vignette study. Eat Disord. 2019:1–17.
Ivezaj V, Wiedemann AA, Grilo CM. Food addiction and bariatric surgery: a systematic review of the literature. Obes Rev. 2017;18(12):1386–97.
Pepino MY, Stein RI, Eagon JC, Klein S. Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity. Obesity (Silver Spring). 2014;22(8):1792–8.
Sevincer GM, Konuk N, Bozkurt S, Coskun H. Food addiction and the outcome of bariatric surgery at 1-year: prospective observational study. Psychiatry Res. 2016;244:159–64.
Brunault P, Gohier B, Ducluzeau PH, Bourbao-Tournois C, Frammery J, Reveillere C, et al. [The psychiatric, psychological and addiction evaluation in bariatric surgery candidates: what should we assess, why and how?]. Presse Med. 2015.
Koball AM, Clark MM, Collazo-Clavell M, Kellogg T, Ames G, Ebbert J, et al. The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery. Surg Obes Relat Dis. 2015.
Miller-Matero LR, Armstrong R, McCulloch K, Hyde-Nolan M, Eshelman A, Genaw J. To eat or not to eat; is that really the question? An evaluation of problematic eating behaviors and mental health among bariatric surgery candidates. Eat Weight Disord. 2014;19(3):377–82.
Meule A, Heckel D, Jurowich CF, Vogele C, Kubler A. Correlates of food addiction in obese individuals seeking bariatric surgery. Clin Obes. 2014;4(4):228–36.
Meule A, de Zwaan M, Muller A. Attentional and motor impulsivity interactively predict ‘food addiction’ in obese individuals. Compr Psychiatry. 2017;72:83–7.
Baldofski S, Tigges W, Herbig B, Jurowich C, Kaiser S, Stroh C, et al. Nonnormative eating behavior and psychopathology in prebariatric patients with binge-eating disorder and night eating syndrome. Surg Obes Relat Dis. 2015;11(3):621–6.
Ames GE, Heckman MG, Diehl NN, Grothe KB, Clark MM. Further statistical and clinical validity for the weight efficacy lifestyle questionnaire-short form. Eat Behav. 2015;18:115–9.
Clark SM, Saules KK. Validation of the Yale food addiction scale among a weight-loss surgery population. Eat Behav. 2013;14(2):216–9.
Fowler L, Ivezaj V, Saules KK. Problematic intake of high-sugar/low-fat and high glycemic index foods by bariatric patients is associated with development of post-surgical new onset substance use disorders. Eat Behav. 2014;15(3):505–8.
Reslan S, Saules KK, Greenwald MK, Schuh LM. Substance misuse following Roux-en-Y gastric bypass surgery. Substance use & misuse. 2014;49(4):405–17.
Vidot DC, Prado G, De La Cruz-Munoz N, Spadola C, Cuesta M, Messiah SE. Postoperative marijuana use and disordered eating among bariatric surgery patients. Surg Obes Relat Dis. 2016;12(1):171–8.
Gearhardt AN, White MA, Potenza MN. Binge eating disorder and food addiction. Curr Drug Abuse Rev. 2011;4(3):201–7.
Gearhardt AN, Corbin WR. The role of food addiction in clinical research. Curr Pharm Des. 2011;17(12):1140–2.
Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, Brownell KD. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68(8):808–16.
Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL. Evidence that ‘food addiction’ is a valid phenotype of obesity. Appetite. 2011;57(3):711–7.
Ziauddeen H, Fletcher PC. Is food addiction a valid and useful concept? Obes Rev. 2013;14(1):19–28.
Meule A, Gearhardt AN. Food addiction in the light of DSM-5. Nutrients. 2014;6(9):3653–71.
Amianto F, Ottone L, Abbate Daga G, Fassino S. Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC psychiatry. 2015;15:70.
Marlatt GA. Harm reduction: come as you are. Addict Behav. 1996;21(6):779–88.
Magill M, Kiluk BD, McCrady BS, Tonigan JS, Longabaugh R. Active ingredients of treatment and client mechanisms of change in behavioral treatments for alcohol use disorders: progress 10 years later. Alcohol Clin Exp Res. 2015;39(10):1852–62.
Timko C, Moos RH, Finney JW, Lesar MD. Long-term outcomes of alcohol use disorders: comparing untreated individuals with those in alcoholics anonymous and formal treatment. J Stud Alcohol. 2000;61(4):529–40.
Scott CK, Dennis ML, Laudet A, Funk RR, Simeone RS. Surviving drug addiction: the effect of treatment and abstinence on mortality. Am J Public Health. 2011;101(4):737–44.
Logan DE, Marlatt GA. Harm reduction therapy: a practice-friendly review of research. J Clin Psychol. 2010;66(2):201–14.
Mosinski JD, Kirwan JP. Longer-term physiological and metabolic effects of gastric bypass surgery. Curr Diab Rep. 2016;16(6):50.
Steele KE, Prokopowicz GP, Schweitzer MA, Magunsuon TH, Lidor AO, Kuwabawa H, et al. Alterations of central dopamine receptors before and after gastric bypass surgery. Obes Surg. 2010;20(3):369–74.
Dunn JP, Cowan RL, Volkow ND, Feurer ID, Li R, Williams DB, et al. Decreased dopamine type 2 receptor availability after bariatric surgery: preliminary findings. Brain Res. 2010;1350:123–30.
Patriti A, Facchiano E, Gulla N, Aisa MC, Annetti C. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg. 2007;245(1):157–8.
Olbers T, Bjorkman S, Lindroos A, Maleckas A, Lonn L, Sjostrom L, et al. Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg. 2006;244(5):715–22.
Schultes B, Ernst B, Wilms B, Thurnheer M, Hallschmid M. Hedonic hunger is increased in severely obese patients and is reduced after gastric bypass surgery. Am J Clin Nutr. 2010;92(2):277–83.
Thirlby RC, Bahiraei F, Randall J, Drewnoski A. Effect of Roux-en-Y gastric bypass on satiety and food likes: the role of genetics. J Gastrointest Surg. 2006;10(2):270–7.
Tichansky DS, Glatt AR, Madan AK, Harper J, Tokita K, Boughter JD. Decrease in sweet taste in rats after gastric bypass surgery. Surg Endosc. 2011;25(4):1176–81.
Hajnal A, Kovacs P, Ahmed T, Meirelles K, Lynch CJ, Cooney RN. Gastric bypass surgery alters behavioral and neural taste functions for sweet taste in obese rats. Am J Physiol Gastrointest Liver Physiol. 2010;299(4):G967–79.
le Roux CW, Bueter M, Theis N, Werling M, Ashrafian H, Lowenstein C, et al. Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol. 2011;301(4):R1057–66.
Thomas JR, Marcus E. High and low fat food selection with reported frequency intolerance following Roux-en-Y gastric bypass. Obes Surg. 2008;18(3):282–7.
Berthoud HR, Zheng H, Shin AC. Food reward in the obese and after weight loss induced by calorie restriction and bariatric surgery. Ann N Y Acad Sci. 2012;1264:36–48.
Leahey TM, Bond DS, Raynor H, Roye D, Vithiananthan S, Ryder BA, et al. Effects of bariatric surgery on food cravings: do food cravings and the consumption of craved foods “normalize” after surgery? Surg Obes Relat Dis. 2012;8(1):84–91.
King WC, Belle SH, Hinerman AS, Mitchell JE, Steffen KJ, Courcoulas AP. Patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass: a multicenter prospective cohort study. Ann Surg. 2019.
Smith KE, Orcutt M, Steffen KJ, Crosby RD, Cao L, Garcia L, et al. Loss of control eating and binge eating in the 7 years following bariatric surgery. Obes Surg. 2019;29(6):1773–80.
Blum K, Bailey J, Gonzalez AM, Oscar-Berman M, Liu Y, Giordano J, et al. Neuro-genetics of reward deficiency syndrome (RDS) as the root cause of “addiction transfer”: a new phenomenon common after bariatric surgery. J Genet Syndr Gene Ther. 2011;2012(1).
Steffen KJ, Engel SG, Wonderlich JA, Pollert GA, Sondag C. Alcohol and other addictive disorders following bariatric surgery: prevalence, risk factors and possible etiologies. Eur Eat Disord Rev. 2015.
King WC, Chen JY, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG, et al. Prevalence of alcohol use disorders before and after bariatric surgery. Jama. 2012;307(23):2516–25.
King WC, Chen JY, Courcoulas AP, Dakin GF, Engel SG, Flum DR, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis. 2017;13(8):1392–402.
White GE, Courcoulas AP, King WC. Drug- and alcohol-related mortality risk after bariatric surgery: evidence from a 7-year prospective multicenter cohort study. Surg Obes Relat Dis. 2019;15(7):1160–9.
Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Food Addiction
About this article
Cite this article
Koball, A.M., Ames, G., Goetze, R.E. et al. Bariatric Surgery as a Treatment for Food Addiction? A Review of the Literature. Curr Addict Rep (2020). https://doi.org/10.1007/s40429-020-00297-w
- Food addiction
- Treatment for food addiction
- Problematic eating behaviors
- Bariatric surgery