AUTHOR=Ban Xu-Yan , Wang Chen , Xu Ting , Liu Lin , Yin Chuan-Yu , Zhang Hui-Lin , Zhang Hong-Wei , Han Xiao-Dong , Zheng Hui , Di Jian-Zhong 

TITLE=When bariatric surgery reduces food addiction: a prospective study

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1535911

DOI=10.3389/fnut.2025.1535911

ISSN=2296-861X

ABSTRACT=BackgroundStudies have shown that patients with obesity appear to be more susceptible to food addiction than the general population. Bariatric surgery stands as the most potent remedy for combating obesity, and it is believed to alleviate the manifestations of food addiction. However, the timing of bariatric surgery to improve food addiction has seldom been the focus of attention.MethodsIn this research, 78 individuals who underwent bariatric surgery were tracked over a period of 2 years. The Yale Food Addiction Scale 2.0 (YFAS 2.0) was employed to assess changes in food addiction tendencies post-surgery. Mixed linear modeling and cluster analysis were applied to investigate the timing of influence of bariatric surgery on the evolution of sub domains of food addiction.ResultsWe found that: (1) Bariatric surgery significantly reduces food addiction scores; (2) Bariatric surgery rapidly reduces food addiction scores within first month of surgery and extends to 2 years after surgery; (3) Symptoms in the YFAS 2.0 could be divided into two domains (rapid decline / slow decline) based on their progression following surgery. Rapid decline domain experience rapid improvement shortly (usually 1st month) after the bariatric surgery and maintains a consistently low symptom level, while the slow decline domain improves slowly (usually 4th month) in the post-operative phase.DiscussionBariatric surgery induced rapid and sustained remission of food addiction, significantly reducing total food addiction scores within 1 month postoperatively. The effects maintained through 24 months, potentially through neurophysiological and gut microbiota alterations. Despite rapid remission of most food addiction symptoms, social/interpersonal problems, hazardous use, and large amount/longer showed delayed improvement, suggesting distinct behavioral persistence mechanisms.ConclusionFood addiction scores can rapidly decline postoperatively and remain consistently lower. However, bariatric surgery does not fully improve all addiction symptoms at the 1st month. This suggests the importance of establishing multidisciplinary clinics in bariatric metabolic surgery.