Sophie Meillon

Link Between Increased Satiety Gut Hormones and Reduced Food Reward After Gastric Bypass Surgery for Obesity

Context: Roux-en-Y gastric bypass (RYGB) surgery is an effective long-term intervention for weight loss maintenance, reducing appetite, and also food reward, via unclear mechanisms. Objective: To investigate the role of elevated satiety gut hormones after RYGB, we examined food hedonic-reward responses after their acute post-prandial suppression. Design: These were randomized, placebo-controlled, double-blind, crossover experimental medicine studies. Patients: Two groups, more than 5 months after RYGB for obesity (n = 7–11), compared with nonobese controls (n = 10), or patients after gastric banding (BAND) surgery (n = 9) participated in the studies. Intervention: Studies were performed after acute administration of the somatostatin analog octreotide or saline. In one study, patients after RYGB, and nonobese controls, performed a behavioral progressive ratio task for chocolate sweets. In another study, patients after RYGB, and controls after BAND surgery, performed a functional magnetic resonance imaging food picture evaluation task. Main Outcome Measures: Octreotide increased both appetitive food reward (breakpoint) in the progressive ratio task (n = 9), and food appeal (n = 9) and reward system blood oxygen level-dependent signal (n = 7) in the functional magnetic resonance imaging task, in the RYGB group, but not in the control groups. Results: Octreotide suppressed postprandial plasma peptide YY, glucagon-like peptide-1, and fibroblast growth factor-19 after RYGB. The reduction in plasma peptide YY with octreotide positively correlated with the increase in brain reward system blood oxygen level-dependent signal in RYGB/BAND subjects, with a similar trend for glucagon-like peptide-1. Conclusions: Enhanced satiety gut hormone responses after RYGB may be a causative mechanism by which anatomical alterations of the gut in obesity surgery modify behavioral and brain reward responses to food.

Sensory-specific satiety for a food is unaffected by the ad libitum intake of other foods during a meal. Is SSS subject to dishabituation?

Sensory-specific satiety (SSS) is defined as a decrease in the pleasantness of a specific food that has just been eaten to satiation, while other non-eaten foods remain pleasant. The objectives of this study were the following: (1) to investigate whether SSS for a food is affected by the ad libitum intake of other foods presented sequentially during a meal, (2) to compare the development of SSS when foods are presented simultaneously or sequentially during a meal, and (3) to examine whether SSS is modified when foods are presented in an unusual order within a meal. Twelve participants participated in three tasting sessions. In session A, SSS for protein-, fat- and carbohydrate-rich sandwiches was measured after the ad libitum consumption of single type of each of these foods. In session B, SSS was measured for the same three foods consumed ad libitum but presented simultaneously. Session C was identical to session A, except that the presentation order of the three foods was reversed. The results indicate that once SSS for a given food is reached, the ad libitum consumption of other foods with different sensory characteristics does not decrease SSS, regardless of the order in which the foods are presented. Once reached, SSS is thus not subject to dishabituation during a meal.

Prandial States Modify the Reactivity of the Gustatory Cortex Using Gustatory Evoked Potentials in Humans.

Previous functional Magnetic Resonance Imaging studies evaluated the role of satiety on cortical taste area activity and highlighted decreased activation in the orbito-frontal cortex when food was eaten until satiation. The modulation of orbito-frontal neurons (secondary taste area) by ad libitum food intake has been associated with the pleasantness of the foods flavor. The insula and frontal operculum (primary taste area) are also involved in reward processing. The aim was to compare human gustatory evoked potentials (GEP) recorded in the primary and secondary gustatory cortices in a fasted state with those after food intake. Fifteen healthy volunteers were enrolled in this observational study. In each of two sessions, two GEP recordings were performed (at 11:00 am and 1:30 pm) in response to sucrose gustatory stimulation, and a sucrose-gustatory threshold was determined. During one session, a standard lunch was provided between the two GEP recordings. During the other session, subjects had nothing to eat. Hunger sensation, wanting, liking, and the perception of the solutions intensity were evaluated with visual analog scales. GEP latencies measured in the Pz (p < 0.001), Cz (p < 0.01), Fz (p < 0.001) recordings (primary taste area) were longer after lunch than in the pre-prandial condition. Fp1 and Fp2 latencies (secondary taste area) tended to be longer after lunch, but the difference was not significant. No difference was observed for the sucrose-gustatory threshold regardless of the session and time. Modifications in the primary taste area activity during the post-prandial period occurred regardless of the nature of the food eaten and could represent the activity of the frontal operculum and insula, which was recently shown to be modulated by gut signals (GLP-1, CCK, ghrelin, or insulin) through vagal afferent neurons or metabolic changes of the internal milieu after nutrient absorption. This trial was registered at clinicalstrials.gov as NCT02472444.