Abstract
The influence of metabolic and bariatric surgery (MBS) on taste preferences and the pleasurable aspects of appetite may be mediated through its effects on gut hormones, potentially affecting weight loss results. Research indicates that the nature of the MBS performed significantly impacts food cravings in the year following the procedure, with no clear relationship to psychological factors or pre-surgery eating behaviors. During the period from August 2021 to August 2022, a group of adult patients with a body mass index (BMI) of 40 kg/m2 or above, or 35 kg/m2 or above with obesity-related medical complications, underwent Roux-en-Y gastric bypass (RYGB), one-anastomosis gastric bypass (OAGB), or sleeve gastrectomy (SG) at a tertiary academic center focused on MBS. This research included 294 patients who completed the Taste Desire and Enjoyment Change Questionnaire (TDECQ) one year after their surgical procedures, which were primary RYGB, OAGB, or SG. Most participants noted changes in their taste perception, cravings, and enjoyment of flavors after undergoing SG, RYGB, and OAGB. The study’s findings suggest that the type of MBS significantly affects taste preferences. Additionally, RYGB and OAGB were associated with a more substantial decrease in the craving for sweet and fatty flavors relative to SG.
Keywords: Bariatric surgery, Metabolic surgery, Taste preferences, Weight loss
Subject terms: Endocrinology, Medical research
Introduction
Despite the introduction of new treatment modalities for obesity, metabolic and bariatric surgery (MBS) remains the most effective approach for managing this chronic condition across various age demographics and types of obesity-associated medical conditions1 such as type 2 diabetes mellitus (T2DM), hypertension (HTN), dyslipidemia (DLP), and obstructive sleep apnea (OSA)2.
MBS may influence taste preferences and the hedonic aspects of appetite may be mediated by its effects on gut hormones, which could subsequently impact weight loss outcomes3,4. Evidence suggests that food cravings during the year following MBS are significantly affected by the type of MBS conducted, with no apparent connection to psychological factors or eating behaviors observed before the surgery5. Sleeve Gastrectomy (SG), Roux-en-Y Gastric Bypass (RYGB), and One Anastomosis Gastric Bypass (OAGB) are the most common MBS procedures around the world6 with approved efficacy and safety for treating severe obesity and obesity-associated medical problems.
Alterations in taste perception, particularly a diminished craving for sweet and fatty foods, may enhance patients’ compliance with nutritional recommendations and ensure sufficient protein consumption. This, in turn, can lead to more effective weight loss outcomes and decrease the likelihood of recurrent weight gain following MBS4.
The purpose of this research was to evaluate taste preferences and to compare the alterations identified before and one year after SG, RYGB, and OAGB.
Methods
Between August 2021 and August 2022, the consecutive adult patients (18–65 years) with BMI ≥ 40 kg/m2 or ≥ 35 kg/m2 with obesity-associated medical problems such as T2DM, DLP, HTN, and OSA, underwent RYGB, OAGB, or SG at our IFSO-EC endorsed academic and tertiary center for MBS by three experienced metabolic and bariatric surgeons were enrolled in this study. This study included 294 patients who completed the Taste Desire and Enjoyment Change Questionnaire (TDECQ) one year after their surgical interventions, which consisted of RYGB, OAGB, or SG as the primary MBS. The MBS methods were selected according to the patients’ criteria such as eating behavior, upper gastrointestinal endoscopic findings, the presence and severity of gastroesophageal reflux disease (GERD), and obesity-associated medical problems. For example, the patients with severe GERD were offered for RYGB and the sweet eater or snacker patients were scheduled for gastric bypass7. The demographic data for these patients was obtained from the Iran National Obesity Surgery Database (INOSD)8.
Taste desire and enjoyment change questionnaire
The Taste Desire and Enjoyment Change Questionnaire (TDECQ)9 is a specialized questionnaire, comprising 24 questions that utilize a Likert scale ranging from 1 to 5 (Much weaker flavor/taste [1]; Weaker flavor/taste [2]; No change in the strength of flavor/taste [3]; Stronger flavor/taste [4]; Much stronger flavor/taste [5]. The TDECQ evaluates how individuals’ preferences, cravings, and satisfaction with particular foods or beverages have evolved or stayed the same after undergoing MBS. Before the initiation of the study, the TDECQ was reviewed by experts in education and health to assess its content and clarity.
Surgical technique
SG
Under general anesthesia, patients were positioned in the French and slightly reversed Trendelenburg orientation. After the insufflation of CO2 via a Veress needle and the placement of five trocars, the surgical procedure was performed using a 36-French bougie and purple linear 60-mm endo-staplers, positioned 4 cm proximal to the pylorus, following the release of the angle of His and gastrolysis. The procedure was finalized with omentopexy.
RYGB
In line with the previously detailed preliminary procedures, a 6-cm narrow gastric pouch was constructed over a 36-French bougie. A 30-mm gastrojejunostomy was formed using a linear tan endo-stapler, which included a 125-cm biliopancreatic limb. Following this, a jejunojejunostomy was created with a 45-mm white endo-stapler to produce a 75-cm alimentary limb. The closure of both Petersen and jejunojejunal defects was accomplished with non-absorbable sutures (Prolene 2–0).
OAGB
Upon completing the initial steps, a narrow pouch developed over a 36-Fr tube distal to the Crow’s foot to make it as long as possible. Following this, a side-to-side gastrojejunostomy was constructed with a linear 30-mm tan endo-stapler, applied at a distance of 160 and 200 cm from the Treitz ligament, in individuals with a BMI of 40 to 50 kg/m2 and those with a BMI of 50 kg/m2 or more according to our center policy10.
Statistical analysis
Continuous and categorical data were described using mean and standard deviation as well as counts and percentages, respectively. Kolmogorov–Smirnov tests were used to test the normality of distributions among continuous variables. The chi-square test or Fischer’s exact test was used for comparing responses of questionnaires between three types of MBS. Multivariate analysis graphs were used to show the degree of change in taste, desire, and enjoyment between three types of surgery (TDECQ Likert scale labels are recorded, for better understanding, as 1 = − 2, 2 = − 1, 3 = 0, 4 = 1, and 5 = 2). Data analyses were conducted using STATA Software (Release 16.1, Stata Corp LLG, College Station, TX, USA, 2019). For all analyses, p-values of 0.05 or less were considered statistically significant.
Ethical approval
The current study received approval from the Ethics Committee of Iran University of Medical Sciences IR.IUMS.FMD.REC.1402.114. The research adhered to the principles outlined in the Declaration of Helsinki. As per these guidelines, written informed consent was obtained from all participants before their involvement in the study.
Results
This study included 294 patients who underwent SG (n = 90), RYGB (n = 104) and OAGB (n = 100) 78.6% (53/71) of the study population was female, and the mean age 12 months after surgery was 39.08 years. The mean BMI before and after surgery was 42.39 kg/m2 and 28.30 kg/m2, respectively. The mean TWL% after surgery was 33.09% (Table 1). In terms of TWL%, the OAGB group exhibited a higher mean (34.03 ± 5.99) than the SG group (32.76 ± 5.89) and the RYGB group (32.46 ± 5.88). Nonetheless, the differences observed among the three groups did not reach statistical significance (P-value: 0.141).
Table 1.
Participant characteristics.
| Variables | (n = 298) |
|---|---|
| Age | 39.08 ± 9.57 |
| Gender, F | 231 (78.6) |
| Type of surgery | |
| SG | 90 (30.6) |
| RYGB | 104 (35.4) |
| OAGB | 100 (34.0) |
| BMI at MBS, kg/m2 | 42.39 ± 5.71 |
| BMI postop, kg/m2 | 28.30 ± 4.15 |
| TWL% | 33.09 ± 5.94 |
*All data are presented as Mean ± SD or number (%).
The most decreased desire for sweet flavor was seen in RYGB (48.1%), OAGB (48%), and SG (28.9%), respectively. Whereas, the most decreased enjoyment of sweet foods was seen in OAGB (48.1%), RYGB (47.1%), and SG (32.2%). The most decreased desire and enjoyment of fatty flavor were reported in RYGB (77.9%, 73.1%), OAGB (72%, 73%), and SG (55.6%, 58.9%) groups (Tables 3, 4).
Figures 1, 2, and 3 show the means and 95% confidence intervals of the difference between three groups of surgery in changes in taste, desire, and enjoyment. There is no obvious difference between SG, OAGB and RYGB in the intensity of taste, desire, and enjoyment perception.
Fig. 1.
Change in taste, desire, and enjoyment 12 months after SG.
Fig. 2.
Change in taste, desire, and enjoyment 12 months after RYGB.
Fig. 3.
Change in taste, desire, and enjoyment 12 months after OAGB.
The intensity of Flavor changes 12 Months after three types of surgery
The OAGB group exhibited a diminished perception of the taste of various food categories, including salty foods (10%), sweet foods (21%), fatty foods (31%), sour foods (13%), and savory foods (17%), when compared to other forms of MBS. In contrast, the SG group demonstrated the most significant reduction in the perception of spicy foods, bitter foods, and metallic foods and liquids, with decreases of 15.6%, 11.1%, and 10%, respectively. Conversely, the RYGB group reported a heightened perception of sweet foods, fatty foods, sour foods, and savory foods, with values of 21.2%, 28.8%, 19.2%, and 12.5%. Notably, the diminished perception of fatty foods in the OAGB group was statistically significant (Table 2).
Table 2.
Change in taste of food based on TDEQ through SG, RYGB and OAGB.
| Variables | Status | RYGB (n = 104) |
OAGB (n = 100) |
SG (n = 90) |
P-Value |
|---|---|---|---|---|---|
| Q1_salty | No change | 86 (82.7) | 81 (81.0) | 72 (80.0) | 0.888 |
| Decrease | 5 (4.8) | 10 (10.0) | 5 (5.6) | 0.289 | |
| Increase | 13 (12.5) | 9 (9.0) | 13 (14.4) | 0.498 | |
| Q2_ sweet | No change | 62 (59.6) | 65 (65.0) | 62 (68.9) | 0.398 |
| Decrease | 20 (19.2) | 21 (21.0) | 10 (11.1) | 0.163 | |
| Increase | 22 (21.2) | 14 (14.0) | 18 (20.0) | 0.373 | |
| Q3_fatty | No change | 46 (44.2) | 54 (54.0) | 50 (55.6) | 0.222 |
| Decrease | 28 (26.9) | 31 (31.0) | 25 (27.8) | 0.796 | |
| Increase | 30 (28.8) | 15 (15.0) | 15 (16.7) | 0.028* | |
| Q4_sour | No change | 75 (72.1) | 73 (73.0) | 71 (78.9) | 0.511 |
| Decrease | 9 (8.7) | 13 (13.0) | 5 (5.6) | 0.202 | |
| Increase | 20 (19.2) | 14 (14.0) | 14 (15.6) | 0.583 | |
| Q5_savoury | No change | 75 (72.1) | 75 (75.0) | 68 (75.6) | 0.837 |
| Decrease | 16 (15.4) | 17 (17.0) | 14(15.6) | 0.943 | |
| Increase | 13 (12.5) | 8 (8.0) | 8 (8.9) | 0.522 | |
| Q6_spicy | No change | 78 (75.0) | 75 (75.0) | 72 (80.0) | 0.648 |
| Decrease | 11 (10.6) | 14 (14.0) | 14 (15.6) | 0.574 | |
| Increase | 15 (14.4) | 11 (11.0) | 4 (4.4) | 0.069 | |
| Q7_bitter | No change | 85 (81.7) | 80 (80.0) | 76 (84.4) | 0.726 |
| Decrease | 11 (10.6) | 9 (9.0) | 10 (11.1) | 0.880 | |
| Increase | 8 (7.7) | 11 (11.0) | 4 (4.4) | 0.243 | |
| Q8_metalic | No change | 88 (84.6) | 83 (83.0) | 76 (84.4) | 0.943 |
| Decrease | 9 (8.7) | 7 (7.0) | 9 (10.0) | 0.759 | |
| Increase | 7 (6.7) | 10 (10.0) | 5 (5.6) | 0.476 |
*All data are presented as number (%).
Intensity of desire change 12 months after three types of surgery
The OAGB group exhibited a higher frequency of diminished desire for sweet flavors (48.1%), fatty flavors (77.9%), and savory foods (36.5%). Conversely, the SG group reported the most significant reduction in desire for salty taste (30%) and bitter foods (17.8%). Additionally, the OAGB group showed the greatest decrease in desire for sour and spicy foods, with changes of 36% and 29%, respectively. No significant differences were observed among the three types of surgery regarding the weaker change in desire for all eight taste categories. In contrast, the RYGB group demonstrated a notable increase in desire for salty foods, sour foods, savory foods, bitter foods, and metallic foods and liquids, with increases of 28.8%, 26%, 14.4%, 12.5%, and 12.5%, respectively. The SG group also had the highest percentage of no change in desire for sweet, fatty, and sour tastes, recorded at 38.9%, 41.1%, and 58.9%, which was statistically significant (Table 3).
Table 3.
Change in desire for food based on TDEQ through SG, RYGB, and OAGB.
| Status | SG (n = 90) |
RYGB (n = 104) |
OAGB (n = 100) |
P-Value | |
|---|---|---|---|---|---|
| Q9_salty | No change | 44 (48.9) | 45 (43.3) | 57 (57.0) | 0.144 |
| Decrease | 27 (30.0) | 29 (27.9) | 23 (23.0) | 0.531 | |
| Increase | 19 (21.1) | 30 (28.8) | 20 (20.0) | 0.269 | |
| Q10_sweet | No change | 35 (38.9) | 25 (24.0) | 23 (23.0) | 0.026* |
| Decrease | 26 (28.9) | 50 (48.1) | 48 (48.0) | 0.009* | |
| Increase | 29 (32.2) | 29 (27.9) | 29 (29.0) | 0.794 | |
| Q11_fatty | No change | 37 (41.1) | 19 (18.3) | 22 (22.0) | 0.001* |
| Decrease | 50 (55.6) | 81 (77.9) | 72 (72.0) | 0.003* | |
| Increase | 3 (3.3) | 4 (3.8) | 6 (6.0) | 0.630 | |
| Q12_sour | No change | 53 (58.9) | 45 (43.3) | 41 (41.0) | 0.028* |
| Decrease | 26 (28.9) | 32 (30.8) | 36 (36.0) | 0.546 | |
| Increase | 11 (12.2) | 27 (26.0) | 23 (23.0) | 0.050 | |
| Q13_savoury | No change | 58 (64.4) | 51 (49.0) | 58 (58.0) | 0.093 |
| Decrease | 28 (31.1) | 38 (36.5) | 30 (30.0) | 0.568 | |
| Increase | 4 (4.4) | 15 (14.4) | 12 (12.0) | 0.066 | |
| Q14_spicy | No change | 63 (70.0) | 69 (66.3) | 65 (65.0) | 0.753 |
| Decrease | 24 (26.7) | 29 (27.9) | 29 (29.0) | 0.938 | |
| Increase | 3 (3.3) | 6 (5.8) | 6 (6.0) | 0.656 | |
| Q15_bitter | No change | 63 (70.0) | 77 (74.0) | 80 (80.0) | 0.277 |
| Decrease | 16 (17.8) | 14 (13.5) | 15 (15.0) | 0.703 | |
| Increase | 11 (12.2) | 13 (12.5) | 5 (5.0) | 0.133 | |
| Q16_metallic | No change | 50 (55.6) | 53 (51.0) | 63 (63.0) | 0.218 |
| Decrease | 30 (33.3) | 38 (36.5) | 29 (29.0) | 0.518 | |
| Increase | 10 (11.1) | 13 (12.5) | 8 (8.0) | 0.566 |
*All data are presented as number (%).
Intensity of enjoyment change 12 months after three types of surgery
The findings reveal that the highest frequency of reduced enjoyment for salty, spicy, and metallic foods was observed in the SG groups, with rates of 32.2%, 32.2%, and 13.3%, respectively. In contrast, the RYGB group exhibited a notable decrease in enjoyment for fatty, bitter, and savory foods, with frequencies of 73.1%, 38.5%, and 36.5%. Additionally, the OAGB groups reported the most significant reduction in enjoyment for sweet and sour foods, at 48% and 32%, respectively (refer to Table 4). There were no significant differences among the three types of surgery regarding the decrease in enjoyment across seven food tastes, except for sweet foods. The RYGB group reported the most substantial increase in enjoyment for salty, sour, savory, bitter, and metallic foods, with increases of 28.8%, 26%, 14.4%, 12.5%, and 12.5%, respectively. The OAGB group showed increases for fatty and spicy foods at 6% each, while the SG group experienced the highest increase in enjoyment for sweet foods at 32.2%. No significant differences were found among the three types of MBS concerning the increase in enjoyment across eight food tastes (Table 4).
Table 4.
Change in enjoyment of food based on TDEQ through SG, RYGB and OAGB.
| Status | SG (n = 90) |
RYGB (n = 104) |
OAGB (n = 100) |
P-Value | |
|---|---|---|---|---|---|
| Q17_salty | No change | 41 (45.6) | 50 (48.1) | 57 (57.0) | 0.245 |
| Decrease | 29 (32.2) | 32 (30.8) | 20 (20.0) | 0.112 | |
| Increase | 20 (22.2) | 22 (21.2) | 23 (23.0) | 0.950 | |
| Q18_sweet | No change | 35 (38.9) | 28 (26.9) | 25 (25.0) | 0.080 |
| Decrease | 29 (32.2) | 49 (47.1) | 48 (48.0) | 0.050* | |
| Increase | 26 (28.9) | 27 (26.0) | 27 (27.0) | 0.899 | |
| Q19_fatty | No change | 34 (37.8) | 24 (23.1) | 21 (21.0) | 0.019* |
| Decrease | 53 (58.9) | 76 (73.1) | 73 (73.0) | 0.055 | |
| Increase | 3 (3.3) | 4 (3.8) | 6 (6.0) | 0.630 | |
| Q20_sour | No change | 51 (56.7) | 45 (43.3) | 45 (45.0) | 0.135 |
| Decrease | 28 (31.1) | 32 (30.8) | 32 (32.0) | 0.981 | |
| Increase | 11 (12.2) | 27 (26.0) | 23 (23.0) | 0.050* | |
| Q21_savoury | No change | 53 (58.9) | 54 (51.9) | 58 (58.0) | 0.558 |
| Decrease | 32 (35.6) | 38 (36.5) | 30 (30.0) | 0.575 | |
| Increase | 5 (5.6) | 12 (11.5) | 12 (12.0) | 0.257 | |
| Q22_spicy | No change | 59 (65.6) | 65 (62.5) | 68 (68.0) | 0.710 |
| Decrease | 29 (32.2) | 32 (30.8) | 27 (27.0) | 0.715 | |
| Increase | 2 (2.2) | 7 (6.7) | 5 (5.0) | 0.336 | |
| Q23_bitter | No change | 47 (52.2) | 53 (51.0) | 62 (62.0) | 0.229 |
| Decrease | 33 (36.7) | 40 (38.5) | 29 (29.0) | 0.327 | |
| Increase | 10 (11.1) | 11 (10.6) | 9 (9.0) | 0.880 | |
| Q24_metallic | No change | 74 (82.2) | 83 (79.8) | 83 (83.0) | 0.828 |
| Decrease | 12 (13.3) | 10 (9.6) | 12 (12.0) | 0.712 | |
| Increase | 4 (4.4) | 11 (10.6) | 5 (5.0) | 0.162 |
*All data are presented as number (%).
Discussion
MBS is extremely successful in achieving significant and sustained long-term weight loss in comparison to other weight management programs. Furthermore, it has decreased the incidence of new T2DM, HTN, and high cholesterol levels, thereby contributing to an improved quality of life11. Additionally, MBS can impact the perception of taste by altering gut hormone responses like GLP-1 and leptin, which can affect taste sensitivity12. Weight loss outcomes vary among different types of MBS, sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and as well as one anastomosis gastric bypass (OAGB) being the most commonly performed MBS procedures worldwide6.
Procedures like RYGB, SG, and OAGB involve positive modifications to the gastrointestinal anatomy, resulting in constriction and redirection of the digestive system. RYGB can impact bile flow, adipose hormones, and the movement of nutrients, which significantly influence metabolic processes and hormonal control11,13. RYGB and OAGB also bring about a greater release of gut peptides like GLP-1 and PYY after meals, leading to increased feelings of fullness, decreased hunger, and remission of T2DM14. Furthermore, MBS reduces the number of cells producing the hunger-stimulating hormone ghrelin15,16. Changes in the gut microbiome and the absorption of nutrients also contribute to the metabolic advantages seen after all MBS procedures17,18.
SG results in notable reductions in ghrelin levels by removing the gastric fundus, which is the primary source of ghrelin production. Ghrelin serves as the primary hormone produced by the gastric fundus and plays a significant role in regulating appetite as well as in glycemic control19. Furthermore, SG boosts the secretion of GLP-1 and PYY, akin to RYGB, leading to changes in metabolism, taste, and desire reflected in weight loss20. Although SG is considered a restrictive procedure that typically results in minimal nutritional deficiencies, long-term follow-up studies have indicated the occurrence of anemia linked to deficiencies in ferritin and vitamin B1221,22.
Alterations in taste perception and olfactory function are observed after MBS, leading to modifications in food preferences post-surgery23.
Various types of MBS have different effects on the craving for sweet Flavors. Upon conducting an analysis and comparison of the impacts of RYGB, SG, and OAGB, it was observed that both RYGB and OAGB resulted in a more pronounced reduction in the craving for sweet flavors when contrasted with SG. (Table 2).
Our finding showed that the desire for sweets decreased in 48.1%, 48%, and 28.9% of patients after RYGB, OAGB and SG, respectively. Nielsen et al.24 found that individuals who underwent RYGB surgery experienced decreased cravings for sweets. Additionally, Smith et al.15 reported a reduced preference for sucrose-sweetened mixtures among RYGB patients, with more significant weight loss observed in those who had a stronger preference for sweet flavors before the MBS. Furthermore, it is believed that RYGB patients exhibit less activation in reward-related brain areas when exposed to high-calorie foods, including sweets.
The impact of SG on sweet taste sensitivity is not fully understood. Some studies suggest no significant changes in sweet taste sensitivity after the surgery25, while others indicate a potential increase in sensitivity23,26.
In our study, the most significant decline in desire and enjoyment of fatty flavor was observed in individuals who underwent RYGB (77.9%, 73.1%), followed by those who had OAGB (72%, 73%) and SG (55.6%, 58.9%). Studies have shown that patients experience a decreased preference for and consumption of fatty foods post-surgery. A study by Bernard et al.16 showed that RYGB patients had a significant decrease in the desire for fatty foods, with a reduced intake of high-fat foods observed in a buffet meal test.
Smith et al.15 also reported that RYGB patients had a decreased liking for high-fat mixtures, with a greater preoperative preference for fatty flavors being associated with greater weight loss post-surgery. Bernard et al.16 also noted that RYGB patients had a reduced hedonic rating for fatty foods, indicating decreased enjoyment. It may also be associated with hypoabsorption and an increased incidence of diarrhea following the intake of high-fat foods. Furthermore, the compliance of certain patients with the dieticians’ recommendations could contribute to the desired changes.
According to our findings, after SG, patients experience a reduced desire for fatty foods similar to RYGB and OAGB. Studies show improved taste function in SG patients with increased sensitivity to fatty flavors, potentially leading to decreased enjoyment of fatty foods. Zhang et al. reported decreased desire and enjoyment of all tastes except salty and savory in patients who underwent SG4. Our results indicated that 48.9% of patients experienced no alteration in their craving for salty flavors, while 64.4% reported no change in their preference for savory tastes following SG. Additionally, 70% of patients did not exhibit any change in their desire for spicy and bitter flavors after SG.
The overall changes are methodically examined for their impact on taste sensitivity, and perception of taste ultimately influencing the enjoyment of specific types of food. In this study; the diminished perception of fatty foods within the OAGB and RYGB patients appears to be notably more pronounced when compared to other taste categories.
Interestingly, a study by Zhang et al.4 emphasized that preoperative taste preferences could potentially serve as indicators of postoperative weight loss patterns and recurrent weight gain following MBS. This suggests a possible correlation between taste perception and outcomes in weight management. However, sweet eating can be a potential risk factor for suboptimal initial weight loss and recurrent weight gain, and generally, SG is not the procedure of choice in these patients, the findings of our study indicated that there were no statistically significant differences in weight loss results among the three types of MBS after one year. Additionally, we found that only the type of MBS has an impact on taste preferences.
RYGB typically leads to a heightened sensitivity to sweet flavors. According to a study by Al-Alsheikh et al.27, there is an increase in taste detection sensitivity for sweetness shortly after RYGB, and patients exhibit a decreased appetitive reward value for sweet stimuli. We observed that the RYGB group experienced reduced enjoyment of fatty, bitter, and savory foods at the 12-month follow-up.
During follow-up, we noticed that individuals who had undergone OAGB reported experiencing less pleasure when consuming sweet and sour foods compared to other tastes. Furthermore, this particular group exhibited diminished sensitivity to the tastes of saltiness, sweetness, fat, sourness, and savoriness.
In this study, the SG group demonstrated a reduced perception of spicy, bitter, and metallic flavors in both foods and liquids. Melis et al.20 indicated that SG patients experienced an overall enhancement in taste function, with increased sensitivity to sweetness and fatty stimuli. This heightened sensitivity may contribute to reduced consumption of sweets and less enjoyment of fatty foods. Conversely, Berro et al.28 did not observe any improvement in taste identification among SG patients, and noted that the pleasantness of foods worsened postoperatively for the majority of patients. Interestingly, they found that changes in flavor perception were correlated with patients’ age, with younger patients reporting more pronounced alterations in flavor perception.
The study’s limitations include its single-center design, a follow-up period of one year, and its non-randomized nature. Additionally, the assessment of changes in food preferences before and after MBS relied on patients’ perceptions at the time they completed the questionnaire. However, a notable strength of the study lies in the comparison of three prevalent MBS procedures, along with a relatively adequate sample size.
Conclusion
In conclusion, the majority of participants experience changes in taste perception, desire, and enjoyment of flavors after undergoing SG, RYGB, and OAGB. These changes may carry important implications for food preferences and satisfaction with eating behaviors after MBS. The findings revealed that only the type of MBS has an impact on taste preferences. Additionally, it was found that RYGB and OAGB resulted in a more marked decrease in the craving for sweet and fatty flavors when compared to SG. Further studies with larger sample sizes and longer follow-up periods are necessary to strengthen our findings.
Author contributions
N.M., M.S., and M.K. are guarantors of the article. M.K. conceived and designed the study. N.M., M.S., S.S., A.P. and M.K. collected all the data. M.S. performed the data Analysis. N.M., B.I., M.S., S.S., A.P., B.A. and M.K. drafted the manuscript. B.A. and M.K. critically revised the manuscript. All authors had full access to all the data in the study and had responsibility for the decision to submit for publication.
Data availability
The data that support the findings of this study are available from the Iran National Obesity Surgery Database (INOSD) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of INOSD.
Declarations
Competing interests
The authors declare no competing interests.
Ethical approval
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This consensus exercise was approved by the ethical committee of the Iran University of Medical Sciences (IR.IUMS.FMD.REC.1402.114).
Informed consent
Informed consent was obtained from the participants included in the consensus study.
Footnotes
Publisher’s note
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Contributor Information
Masoumeh Shahsavan, Email: mashahsavan@yahoo.com.
Mohammad Kermansaravi, Email: mkermansaravi@yahoo.com.
References
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the Iran National Obesity Surgery Database (INOSD) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of INOSD.