Sensitivity to Sweets Tied to Weight Loss After Bariatric Surgery | Nutrition Fit



Preliminary research from Portugal hints that having a heightened perception of sweetness in a taste test may predict greater weight loss a year after bariatric surgery.

Researchers found that among 96 patients who had bariatric surgery, those with higher presurgery “sweet taste intensity” scores in a test — in which patients tasted strips of paper dipped in sucrose solutions of different strengths — had greater weight loss a year after surgery.

In contrast, patients with higher presurgery scores for “sweet food acceptance” — based on patients’ questionnaire ratings for how much they liked sweet foods (a measure of hedonic reward or pleasure from eating such foods) — had less weight loss at follow-up.

In addition, patients who had a greater drop in scores for either sweet taste intensity or sweet food acceptance (from pre- to postsurgery) also had greater weight loss.

These findings by Gabriela Ribeiro, a registered dietician and PhD fellow in neuroscience, from the Champalimaud Centre for the Unknown, in Lisbon, Portugal, and colleagues, were published February 8 in the American Journal of Clinical Nutrition.

“We showed, for the first time, that preoperative sweet [taste] intensity predicts weight loss after surgery and that postsurgery changes in this variable [track (or predict)] the amount of weight loss in each patient,” they summarize.

Novel and Surprising Findings: Personalize Patient Selection?

“It was surprising to find that two different measures of food reward — in this case, of hedonic hunger and taste perception of sweetness [intensity] — would predict bariatric surgery [weight-loss] outcomes in opposite ways,” Ribeiro admitted.

Similarly, it is “novel and surprising,” that whereas being sensitive to the intensity of a sweet taste was associated with greater weight loss, perceiving a sweet taste as very pleasant did not predict this.

These early results suggest that “the surgically induced readjustment of the weight set point seems to be associated with sweet taste,” the researchers state.

However, these “[sweet] taste-related measures will require further clinical validation,” Ribeiro cautioned in a statement.

More research is also needed to determine the underlying biological mechanisms for these discoveries.

“A better understanding of [biological] mechanisms could have implications in terms of bariatric outcomes improvement — for instance, through a personalized selection of patients,” said Ribeiro, “as well as for the development of novel therapeutic options for patients with obesity, aiming to target those mechanisms.”

Sweet Intensity Ratings and Hedonic Hunger Scores

Bariatric surgery is the most effective treatment for severe obesity, resulting in weight loss, improved comorbidities, and longer life, Ribeiro and colleagues write, but postsurgery weight loss varies from patient to patient.

Those who adopt healthier eating behaviors afterwards have better outcomes, and some evidence shows that following bariatric surgery, patients prefer foods with less fat and sugar — but it is not clear if foods that are high in fat and sugar become less tasty or if people’s appetites shrink.

The researchers hypothesized that mean intensity and pleasantness ratings across four concentrations of sucrose (sweet) taste strips, as well as questionnaire scores for hedonic hunger and addiction-like feeding behavior would predict weight loss after bariatric surgery.

They enrolled 212 patients from three hospitals from November 2012 to June 2017.

In the surgical group, 96 patients — 36 of whom had sleeve gastrectomy and 60 of whom had gastric bypass — had data from a follow-up visit at 11 to 18 months after surgery.

In the control group, which was comprised of patients who consulted for bariatric surgery but never actually had it, 50 individuals had data from a follow-up visit at 2 to 18 months after enrollment.

The researchers estimated how baseline gustatory measures (including intensity and pleasantness ratings for sweet, sour, salt, and bitter tastes) and psychometric measures of reward-related feeding behavior (including food acceptance/hedonic hunger for different foods) predicted weight loss after bariatric surgery.

At baseline, the patients were a mean age of 43 and had a mean body mass index of 43 kg/m2; 85% were women.

On average, at follow-up, participants in the surgical groups had lost 31.9% of their initial weight and those in the control group had lost 1% of their initial weight.

Sweet taste intensity was associated with losing a greater percentage of initial weight in the surgical group but not in the control group.  

Those findings were confirmed in a cohort of 10 patients who had gastric bypass and 6 patients who had sleeve gastrectomy who were followed for 4 years, and 48 healthy controls who were followed for 5.6 years.

The authors have reported no relevant financial relationships.

Am J Clin Nutr. Published online February 8, 2021. Full text

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