Eating behavior in laparoscopic sleeve gastrectomy: Correlation between plasma ghrelin levels and hunger

BACKGROUND: Bariatric procedures like gastric banding, vertically banded gastroplasty and Roux-en-Y gastric bypass have impacted on the postoperative eating behavior. Since laparoscopic sleeve gastrectomy (LSG) leads to decreased plasma ghrelin levels, a reduced sensation of hunger following surgery is expected. The aim of this study was to assess the impact of LSG on the eating behavior in correlation with plasma ghrelin levels. METHODS: This prospective study was carried out in 15 morbidly obese patients who underwent LSG. The German version of the self-report Three-Factor Eating Questionnaire (TFEQ) was applied preoperatively and at six months following surgery to assess the impact of LSG on the three dimensions of eating behavior: restraint, disinhibition and hunger. The correlation between plasma ghrelin levels and the sensation of hunger was assessed in a subset of seven patients. RESULTS: Following LSG, increased cognitive restraint and decreased disinhibition of eating were found. Furthermore, a significant decrease in hunger was observed with a significant correlation (r = 0.834, p = 0.01) between circulating plasma ghrelin levels and hunger scores. CONCLUSIONS: Following LSG, a high correlation between decreased ghrelin levels and the reduced sensation of hunger was found. This may contribute to the excellent weight loss observed following laparoscopic sleeve gastrectomy.