Effects of laparoscopic sleeve gastrectomy on attentional processing of food-related information: Evidence from eye-tracking

Abstract

BackgroundWeight loss after laparoscopic sleeve gastrectomy (LSG) might be associated partially with changes in reward system functioning and altered appetitive responses to food cues. Food cue processing refers to motivational, affective, and cognitive responses to stimuli that are associated with food. We investigated if food cue processing is altered 6 months after weight loss that is induced by LSG. We expected patients after LSG to show reduced appetitive responses to food cues. MethodsIn an experimental longitudinal exploratory study, 17 severely obese patients (body mass index [BMI]: 48.3±6.5 kg/m²) were investigated presurgery and 6 months postsurgery. We used eye-tracking to assess attentional biases during free viewing of food versus nonfood cues, assessed pleasantness ratings of food cues, and self-reported food craving. ResultsAfter LSG, the mean BMI of patients was 36.4±6.0 kg/m², and the percentage of excess weight loss (%EWL) was 46.6%±14.0%. Six months after LSG, patients showed an attentional bias toward nonfood cues compared with presurgery, reported lower food craving, and rated presented food stimuli as less pleasant. ConclusionEvidence of altered food cue processing was found in patients after LSG, which may be interpreted as reduced food reward associated with increased cognitive control. Surgery-induced physiologic, cognitive-motivational, and behavioral changes may lead to a desensitization of the reward system and enhanced cognitive control.