Improvement in Uncontrolled Eating Behavior after Laparoscopic Sleeve Gastrectomy Is Associated with Alterations in the Brain-Gut-Microbiome Axis in Obese Women

• Published in: Nutrients Vol. 12; no. 10; p. 2924
• Main Authors: Dong, Tien S, Gupta, Arpana, Jacobs, Jonathan P, Lagishetty, Venu, Gallagher, Elizabeth, Bhatt, Ravi R, Vora, Priten, Osadchiy, Vadim, Stains, Jean, Balioukova, Anna, Chen, Yijun, Dutson, Erik, Mayer, Emeran A, Sanmiguel, Claudia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24-09-2020; MDPI
• Subjects: Addictions; Adolescent; Adult; Amygdala; Bariatric Surgery; Brain; Brain - metabolism; brain–gut–microbiome axis; Demography; Diet - psychology; Digestive system; Eating; Eating behavior; Female; Food Addiction - psychology; Gastrectomy; Gastrectomy - psychology; Gastrointestinal Microbiome; Gastrointestinal surgery; Health Behavior; Humans; Intestinal microflora; Laparoscopy; Laparoscopy - psychology; Lecithin; Magnetic Resonance Imaging; Medical imaging; metabolite; Metabolites; Metabolomics; Microbiomes; Microbiota; Middle Aged; Neural networks; Neuroimaging; obesity; Obesity - psychology; Obesity - surgery; Phosphatidylcholine; Putamen; Reinforcement; Surgery; Surveys and Questionnaires; Weight Loss; Young Adult; United States > US; bariatric surgery; metabolite; brain; brain–gut–microbiome axis; obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12102924

Bariatric surgery is proven to change eating behavior and cause sustained weight loss, yet the exact mechanisms underlying these changes are not clearly understood. We explore this in a novel way by examining how bariatric surgery affects the brain-gut-microbiome (BGM) axis.
Patient demographics, serum, stool, eating behavior questionnaires, and brain magnetic resonance imaging (MRI) were collected before and 6 months after laparoscopic sleeve gastrectomy (LSG). Differences in eating behavior and brain morphology and resting-state functional connectivity in core reward regions were correlated with serum metabolite and 16S microbiome data.
LSG resulted in significant weight loss and improvement in maladaptive eating behaviors as measured by the Yale Food Addiction Scale (YFAS). Brain imaging showed a significant increase in brain volume of the putamen (
.adj < 0.05) and amygdala (
.adj < 0.05) after surgery. Resting-state connectivity between the precuneus and the putamen was significantly reduced after LSG (
.adj = 0.046). This change was associated with YFAS symptom count.
,
, and
were associated with reduced connectivity between these areas. Metabolomic profiles showed a positive correlation between this brain connection and a phosphatidylcholine metabolite.
Bariatric surgery modulates brain networks that affect eating behavior, potentially through effects on the gut microbiota and its metabolites.