Neural Predictors of 12-Month Weight Loss Outcomes Following Bariatric Surgery
Open accessAbstract
Background/objectives Despite the effectiveness of bariatric surgery, there is still substantial variability in long-term weight outcomes and few factors with predictive power to explain this variability. Neuroimaging may provide a novel biomarker with utility beyond other commonly used variables in bariatric surgery trials to improve prediction of long-term weight-loss outcomes. The purpose of this study was to evaluate the effects of sleeve gastrectomy (SG) on reward and cognitive control circuitry postsurgery and determine the extent to which baseline brain activity predicts weight loss at 12-month postsurgery.Subjects/methods Using a longitudinal design, behavioral, hormone and neuroimaging data (during a desire for palatable food regulation paradigm) were collected from 18 patients undergoing SG at baseline (<1 month prior) and 12-month post-SG.Results SG patients lost an average of 29.0% of their weight (percentage of total weight loss (%TWL)) at 12-month post-SG, with significant variability (range: 16.0-43.5%). Maladaptive eating behaviors (uncontrolled, emotional and externally cued eating) improved (P<0.01), in parallel with reductions in fasting hormones (acyl ghrelin, leptin, glucose, insulin; P<0.05). Brain activity in the nucleus accumbens (NAcc), caudate, pallidum and amygdala during desire for palatable food enhancement vs regulation decreased from baseline to 12 months (P (family-wise error (FWE))<0.05). Dorsolateral and dorsomedial prefrontal cortex activity during desire for palatable food regulation (vs enhancement) increased from baseline to 12 months (P(FWE)<0.05). Baseline activity in the NAcc and hypothalamus during desire for palatable food enhancement was significantly predictive of %TWL at 12 months (P (FWE)<0.05), superior to behavioral and hormone predictors, which did not significantly predict %TWL (P>0.10). Using stepwise linear regression, left NAcc activity accounted for 54% of the explained variance in %TWL at 12 months.Conclusions Consistent with previous obesity studies, reward-related neural circuit activity may serve as an objective, relatively robust predictor of postsurgery weight loss. Replication in larger studies is necessary to determine true effect sizes for outcome prediction.
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After bariatric surgery, foods that are highly palatable and energy dense are most impacted by these neurobiological changes, which, in turn, decrease food intake.
“After having bariatric surgery, foods that are highly palatable and energy dense are most impacted by these neurobiological changes, which, in turn, decrease food intake (56–59).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [56]
The Discussion (page unavailable) reports reduced desire for palatable food and decreased activity in food-reward regions after sleeve gastrectomy. The Methods describe images of highly palatable foods, but the paper does not establish that energy-dense foods are *most* affected or that these neural changes cause a decrease in food intake. (LLM, conf=0.86)
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- Authors
- Holsen, L. M., Davidson, P., Cerit, H., Hye, T., Moondra, P., Haimovici, F., Sogg, S., Shikora, S., Goldstein, J. M., Evins, A. E., & Stoeckel, L. E.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- National Institutes of Health (US)
- Corresponding author
- Holsen, L M
- ORCID
- Venue
- International Journal of Obesity
- Published
- 2017-08-14
- Volume
- 42
- Issue
- 4
- Pages
- 785-793
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- PMC
- PMC6319374
- OpenAlex
- W2747184753
- Cited by
- 69
- References
- 60
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 10 · 2022: 8 · 2021: 19 · 2020: 10 · 2019: 9 · 2018: 3 · 2013: 1
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01MH091222)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK104772, P30DK040561)
- National Center for Research Resources (UL1RR025758)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- bariatric surgery, sleeve gastrectomy, weight loss prediction, nucleus accumbens, reward systems, cognitive control, prefrontal cortex, hypothalamus, maladaptive eating behaviors, ghrelin, leptin, obesity, neuroimaging biomarkers
- MeSH terms
- Adult, Brain, Feeding Behavior, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Weight Loss, Treatment Outcome, Bariatric Surgery, Neuroimaging
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