Bariatric surgery and taste: novel mechanisms of weight loss

Purpose of review The mechanisms by which obesity surgery and in particular gastric bypass cause weight loss are unclear. The review will focus on the concept of alterations in the sense of taste after obesity surgery. Recent findings Patients after obesity surgery and gastric bypass in particular change their eating behaviour and adopt healthier food preferences by avoiding high-calorie and high-fat foods. Patients find sweet and fatty meals less pleasant not due to postingestive side effects but through changes in the sense of taste. The acuity for sweet taste increases after gastric bypass potentially leading to increased intensity of perception. Obese patients experience higher activation of their brain taste reward and addiction centres in response to high calorie and fat tasting. Gastric bypass may reverse these taste hedonics, perhaps through the influence on gustatory pathways caused by enhanced gut hormone responses after surgery. Summary Elucidation of the metabolic mechanism behind the alterations in taste after obesity surgery could lead to the development of novel surgical and nonsurgical procedures for the treatment of obesity.