Changes in food reward are associated with improvements in metabolic markers and eating behaviors after bariatric surgery.

BACKGROUND

Bariatric surgery improves metabolic health and eating behaviors. However, its impact on food reward, particularly liking and wanting, remains poorly understood.

OBJECTIVE

To characterize changes in explicit and implicit food reward following sleeve gastrectomy and to examine their associations with metabolic health and eating behaviors.

METHODS

Food reward was assessed before and 4 months after surgery using the Leeds Food Preference Questionnaire. Eating behaviors, assessed with the Three-Factor Eating Questionnaire, and comprehensive glycemic and lipid profiles were measured at both time points. Linear mixed-effects models were used to assess changes in food reward and their associations with metabolic and behavioral outcomes.

RESULTS

Twenty-nine participants (8 women and 21 men, 39.2 ± 10.7 years, initial BMI: 44.0 ± 4.7 kg/m2) completed both assessments. Explicit and implicit wanting for high-fat sweet foods significantly decreased following bariatric surgery (p < 0.01 and p < 0.001, respectively), whereas explicit liking remained unchanged. Lower implicit wanting for high-fat sweet foods was significantly associated with improvements in eating behaviors and insulin-like growth factor binding protein 2 (IGFBP-2), a marker of glucose metabolism. Exploratory mediation analyses showed that implicit wanting for high-fat sweet foods accounted for 16 to 18% of the association between IGFBP-2 and changes in eating behaviors.

CONCLUSION

Sleeve gastrectomy is associated with reduced motivational drive for high-fat sweet foods, while hedonic appreciation remains stable. These findings suggest that post-surgical metabolic adaptations may improve the control of food intake, in part by modulating implicit motivation for high-fat sweet foods.