Abstract
Surgical weight loss results in a host of metabolic changes that culminate in net positive health benefit to the patients. However, the psychological impact of these surgeries has not been fully studied. On one hand, surgical weight loss has been reported to improve standard quality of life and resolution of symptoms of depression. But on the other hand, reports of self-harm and increased ER visits for self-harm suggest other psychological difficulties. Inability to handle anxiety following surgical weight loss has alarming potential ramifications for these gastric surgery patients. In the present study, we used models of diet-induced obesity and vertical sleeve gastrectomy (VSG) to ask whether anxiety behavior and hypothalamic-pituitary-adrenal (HPA) axis gene changes were affected by surgical weight loss under two diet regimens: i.e. low-fat diet (LFD) and high-fat diet (HFD). We show reduced exploratory behavior in the open field test but increased time in the open arms of the elevated plus maze. Furthermore, we show increased plasma levels of corticosterone in female VSG recipients in the estrus phase and increased levels of hypothalamic arginine-vasopressin (avp), pro-opiomelanocortin (pomc), and tyrosine hydroxylase (th). We report reduced dopamine receptor D1 (drd1) gene in prefrontal cortex (PFC) in VSG animals in comparison to Sham. Further we report diet-driven changes in stress-relevant gene targets in the hypothalamus (oxt, pomc, crhr1) and adrenal (nr3c1, nr3c2, mc2r). Taken together, these data suggest a significant impact of both surgical weight loss and diet on the HPA axis and further impact on behavior. Additional assessment is necessary to determine whether molecular and hormonal changes of surgical weight loss are the source of these findings.
Highlights
Bariatric surgery for the long-term resolution of metabolic dysfunction is highly successful at achieving body weight loss, fat mass reduction, lipid improvements, and reduced need for diabetes medication [1,2,3,4]
vertical sleeve gastrectomy (VSG) animals lost a considerable amount of body weight over whether they were maintained on low-fat diet (LFD) (main effect of surgery, F (1, 160) = 46.89, p < 0.0001) (Fig 1A) or high-fat diet (HFD) (main effect of surgery, F (1, 160) = 38.37, p < 0.0001) (Fig 1B) following the surgery
Average daily food intake was diminished during the first 14 post-operative days (POD) resulting in a cumulative reduction in food intake over the course of the first 3 weeks (main effect of surgery, F (1, 19) = 5.801, p < 0.05) (Fig 1C) but food intake was normalized to the average intake of the ShamLFD and Sham-HFD by POD21
Summary
Bariatric surgery for the long-term resolution of metabolic dysfunction is highly successful at achieving body weight loss, fat mass reduction, lipid improvements, and reduced need for diabetes medication [1,2,3,4]. The potential for these health improvements continues to result in greater numbers of surgeries with each passing year [5, 6]; many of the known negative side. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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