Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity

OBJECTIVE: To test the hypotheses that bariatric surgery-induced weight loss: 1) induces remission of food addiction (FA), and 2) normalizes other eating behaviors associated with FA. DESIGN AND METHODS: Forty-four obese subjects (BMI= 48±8 kg/m(2)) were studied before and after ~20% weight loss induced by bariatric surgery (25 Roux-en-Y gastric bypass, 11 laparoscopic adjustable gastric banding, and 8 sleeve gastrectomy). We assessed: 1) FA (Yale Food Addiction Scale), 2) food cravings (Food Craving Inventory) and 3) restrictive, emotional and external eating behaviors (Dutch Eating Behavior Questionnaire). RESULTS: FA was identified in 32% of subjects before surgery. Compared with non-FA subjects, those with FA craved foods more frequently, and had higher scores for emotional and external eating behaviors (all P-values <0.01; all Cohen’s d >0.8). Surgery-induced weight loss resulted in remission of FA in 93% of FA subjects; no new cases of FA developed after surgery. Surgery-induced weight loss decreased food cravings, and emotional and external eating behaviors in both groups (all P-values <0.001; all Cohen’s d≥0.8). Restrictive eating behavior did not change in non-FA subjects but increased in FA subjects (P<0.01; Cohen’s d>1.1). CONCLUSION: Bariatric surgery-induced weight loss induces remission of FA and improves several eating behaviors that are associated with FA.