REDUCED FOOD-INTAKE AFTER JEJUNOILEAL BYPASS - A POSSIBLE ASSOCIATIONWITH PROLONGED GASTRIC-EMPTYING AND ALTERED GUT HORMONE PATTERNS

The object of this study was to examine whether eating behavior, food preference, gastric emptying, and gut hormone patterns are altered aft er jejunoileal bypass (JIB) in patients with severe obesity. Eight obe se [mean (I SD) body mass index (BMI; in kg/m(2)) 42.9 +/- 4] subjects were studied prospectively before and 9 mo after JIB with eight age- and sex-matched normal-weight control subjects. Total energy intake, d ata from the universal eating monitor (VIKTOR), eating motivation meas ured by visual analog scales, a food-preference checklist, a forced-ch oice list, solid-phase gastric emptying, and postprandial concentratio ns of cholecystokinin, motilin, and neurotensin were studied. BMI was reduced by 29% after JIB. Compared with normal subjects, the JIB patie nts showed a reduced desire to eat, decreased hunger, and reduced pros pective consumption before a test meal. After surgery, obese subjects selected fewer food items and showed a reduced preference for high-car bohydrate and high-fat items before a test meal. There was a trend fro m an accelerated toward a decelerated eating pattern in obese subjects after JIB. After JIB, gastric emptying of obese subjects was slowed a nd similar to that in control subjects. Obese subjects had lower postp randial cholecystokinin concentrations that were lower than those of c ontrol subjects both before and after JIB. Postprandial concentrations of neurotensin were higher after JIB. We conclude that after JIB, the desire to eat and preference for high-carbohydrate and high-fat items is reduced, resulting in decreased energy intake. That gastric emptyi ng is prolonged and gut hormone patterns are altered with low postpran dial plasma cholecystokinin and high neurotensin plasma concentrations may at least partly account for these observations.