Homeostatic, reward and executive brain functions after gastric bypass surgery

Appetite. 2020 Mar 1:146:104419. doi: 10.1016/j.appet.2019.104419. Epub 2019 Aug 28.


Obesity in part arises from the regular overconsumption of palatable, caloric-dense foods. This maladaptive eating behavior has been described as impulsive, compulsive and even addictive, and has its origins in molecular and cellular aberrations in the gut and brain. Mounting evidence from human and rodent studies suggests that Roux-en-Y gastric bypass (RYGB) surgery persistantly promotes lower caloric intake by modifying gut-brain communication. In this Review, we discuss how the changes in gut hormones, nutrient sensing andmicrobiota brought about by RYGB together favourably regulate homeostatic, reward and executive brain functions. We further speculate on how this lastingly establishes a negative whole-body energy balance in the face of plenty. Future studies will more completely characterize the role of modified gut-brain communication in the healthier eating behavior following RYGB, possibly facilitating the development of more effective, non-surgical weight loss treatments.

Keywords: Brain imaging; Food reward; Gut-brain communication; Obesity; Roux-en-Y gastric bypass.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Brain / physiopathology
  • Digestive System Physiological Phenomena*
  • Energy Intake / physiology
  • Executive Function / physiology
  • Feeding Behavior / physiology
  • Gastric Bypass*
  • Gastrointestinal Hormones / metabolism
  • Gastrointestinal Tract / physiopathology
  • Homeostasis / physiology
  • Humans
  • Obesity, Morbid / physiopathology*
  • Obesity, Morbid / psychology*
  • Obesity, Morbid / surgery
  • Postoperative Period
  • Reward
  • Weight Loss / physiology


  • Gastrointestinal Hormones