Skip Navigation
Skip to contents

Ann Clin Nutr Metab : Annals of Clinical Nutrition and Metabolism

Search
Advanced Search
OPEN ACCESS
mobile search button mobile menu button

Articles

Page Path
HOME > Ann Clin Nutr Metab > Volume 16(3); 2024 > Article
Review Changes in perceptions of taste after bariatric surgery: a narrative review
Young Suk Park1,2orcid
Annals of Clinical Nutrition and Metabolism 2024;16(3):120-124.
DOI: https://doi.org/10.15747/ACNM.2024.16.3.120
Published online: December 1, 2024

1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

Corresponding author: Young Suk Park, email: youngsukmd@gmail.com
• Received: October 28, 2024   • Revised: November 22, 2024   • Accepted: November 22, 2024

© 2024 The Korean Society of Surgical Metabolism and Nutrition · The Korean Society for Parenteral and Enteral Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 385 Views
  • 13 Download
prev next
Full Article

Download PDF Download PDF

  • Purpose
    Bariatric surgery effectively treats severe obesity, leading to significant weight loss and improved comorbidities. However, many patients experience postoperative alterations in taste perception, affecting food selection and eating behavior. This narrative review examines the current understanding of taste perception changes following bariatric surgery, including patterns, potential mechanisms, impact on weight loss outcomes, and implications for patient care.
  • Current concept
    Changes in taste perception are frequently reported after bariatric procedures, with prevalence rates from 36% to 72%. Common alterations involve decreased preference and increased sensitivity to sweet and fatty tastes, potentially leading to reduced calorie intake and healthier food choices. Persistence of these changes varies and may depend on surgery type, with Roux-en-Y gastric bypass patients often experiencing more substantial effects than sleeve gastrectomy patients. Potential mechanisms include alterations in gut hormone secretion (e.g., GLP-1, peptide YY, ghrelin), modifications in neural pathways (e.g., vagus nerve), and shifts in the gut microbiome. These factors may collectively influence taste sensitivity and preferences, contributing to weight loss outcomes. Altered reward processing may reduce the appeal of high-calorie foods.
  • Conclusion
    Alterations in taste perception are common after bariatric surgery and may significantly impact dietary behaviors, weight loss, and quality of life. While exact mechanisms are not fully understood, changes in gut hormones, neural pathways, and microbiota are likely involved. Patient counseling and postoperative management of bariatric surgery patients should address potential changes in taste. Further research is needed to elucidate the long-term impacts of taste alterations on weight-loss maintenance and nutritional status.
  • Keywords: Bariatric surgery; Diet, food preference; Obesity; Taste perception; Weight loss
Bariatric surgery has emerged as the most effective long-term treatment for severe obesity, leading to significant weight loss and improvement in obesity-related comorbidities [1]. However, the physiological changes induced by these procedures extend beyond mere calorie restriction and malabsorption. One notable postoperative complication experienced by many bariatric surgery patients is alteration in the perception of taste [2].
Taste plays a crucial role in food selection, intake regulation, and eating behavior. Changes in taste sensitivity and preferences after bariatric surgery may significantly impact a patient’s dietary choices and potentially contribute to the weight loss process [3]. However, these alterations can also present challenges in terms of nutritional intake and quality of life.
This review examines the current understanding of changes in taste perception following bariatric surgery, including the patterns of such changes, potential mechanisms, impact on weight-loss outcomes, and implications for patient care. By synthesizing the available evidence, we hope to provide insights that can inform preoperative counseling and postoperative management strategies for bariatric patients.
The aim of bariatric surgery is to reduce caloric intake and influence hormonal pathways to support weight loss and metabolic improvements.
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most commonly performed bariatric surgical procedures. In RYGB, the stomach is divided into a small upper pouch and a larger bypassed section. The small pouch is then directly connected to the jejunum, bypassing the duodenum and part of the small intestine, which reduces stomach capacity and alters nutrient absorption (Fig. 1). In SG, approximately 75%–80% of the stomach is removed, leaving a narrow, tubular stomach that limits food intake while preserving the natural gastrointestinal pathway (Fig. 2). While both procedures involve significant alterations to the gastrointestinal anatomy, RYGB requires more complex intestinal rerouting than the simpler, stomach-only resection performed in the SG procedure.
Changes in the perception of taste are frequently reported by patients who have undergone bariatric procedures, with the available studies reporting prevalence rates ranging from 36% to 72% [4]. The most commonly reported alterations involve changes in the perception of sweet and fatty tastes, although modifications in other taste modalities have also been documented [5].
The perception of sweet tastes often undergoes significant changes after bariatric surgery. Many patients report a decreased preference for sweet foods and increased sensitivity to sweet tastes [6]. This alteration can manifest as finding previously enjoyed sweet foods overly intense or unpleasant. One study found that the detection threshold for sucrose decreases significantly after RYGB surgery, indicating an increased sensitivity to sweet stimuli [1].
Changes in the perception of fatty tastes are also prominent, with many patients reporting a reduced preference for high-fat foods [7]. This alteration may be partly due to changes in texture perception, as some patients describe fatty foods as feeling “greasy” or unpleasant in the mouth [8].
The persistence of these changes in the perception of taste varies among individuals. Some patients report a normalization of taste perception within months, while others experience long-lasting alterations. Smith et al. [9] found that taste-related changes, such as a reduced preference for high-fat foods, predict weight loss success shortly after surgery, but taste may return to baseline within a year, indicating temporary adjustments in taste. In contrast, Schiavo et al. [10] conducted a study demonstrating that patients reported significant changes in their perception of tastes at 12 months after SG, particularly reduced desire for fatty, sweet, and salty foods and an increased preference for healthier options such as vegetables and fruits.
The pattern and duration of changes in taste perception can differ depending on the type of bariatric procedure performed. Some investigators have highlighted that RYGB and SG patients both self-reported changes in taste, but objective measures showed RYGB to have more substantial effects on food preferences, particularly a reduced preference for high-calorie foods. These findings suggest that the more complex rerouting of the digestive system in RYGB may have a stronger and more persistent effect on taste and food preferences [11].
The mechanisms underlying changes in the perception of taste after bariatric surgery are complex and have not been fully elucidated. While additional study is needed, several candidate mechanisms have been identified (Table 1).
1. Alterations in gut hormones: Bariatric procedures, especially RYGB, lead to significant changes in the secretion of gut hormones such as glucagon-like peptide-1 (GLP-1), peptide YY, and ghrelin [12]. These hormones not only regulate appetite and satiety, but also influence taste perception. For instance, GLP-1 has been shown to modulate sensitivity to sweet tastes in both animal models and human studies [13].
2. Neural pathway modifications: The vagus nerve plays a crucial role in gut-brain communication [14]. Bariatric surgery alters the anatomy and physiology of the gastrointestinal tract, and these alterations may affect the neural pathways involved in taste perception and food reward processing. Several studies have explored the relationship between vagus nerve stimulation and taste perception. Sperling et al. [15] demonstrated that vagus nerve stimulation significantly affected gustatory function in patients with therapy-resistant depression, who reported increased sensitivity to sweet and bitter tastes during vagal stimulation than during non-stimulation periods. In an electrogustometric study of taste perception, regional anesthesia of the inferior alveolar nerve was found to alter thresholds, indicating a role for vagal afferents in modulating taste sensitivity [16].
3. Changes in the gut microbiome: Recent studies have increasingly demonstrated a relationship between the oral microbiome and taste perception microbiomes [17]. Bariatric surgery is known to cause significant changes in the oral microbiome [18]; however, the nature of the relationships between changes in the oral microbiome after bariatric surgery and taste perception is unclear. Gardner et al. [19] reported that microbial metabolites produced in the mouth, such as acetate and butyrate, can reach high concentrations near taste receptors, potentially altering taste perception. Cattaneo et al. [20] found that individual differences in sensitivity to salty, sweet, and bitter foods were associated with distinct oral microbiota compositions, suggesting that microbiome variations may partly explain differences in dietary habits.
The contribution of changes in taste perception to weight loss outcomes after bariatric surgery has been a subject of considerable interest. While a direct causal relationship is challenging to establish, it may be reasonable to assume that alterations in the perception of taste play a role in promoting weight loss.
1. Reduced calorie intake: Changes in taste perception, particularly decreased preference for sweet and high-fat foods, may lead to reduced calorie intake; as a result, bariatric patients may consume significantly fewer calories from sugar and fat than they did prior to surgery [21].
2. Food choice modification: Changes in the perception of taste can prompt patients to modify their food choices, often leading to healthier eating patterns [10]. Increased sensitivity to sweet tastes may encourage patients to choose less sweet alternatives, potentially reducing overall sugar intake.
3. Altered reward processing: Some investigators have suggested that bariatric surgery alters the neural responses to food cues, potentially reducing the rewarding value of high-calorie foods [22]. This change, coupled with alterations in taste perception, may contribute to reduced hedonic eating and improved adherence to dietary recommendations.
However, the relationship between changes in taste perception and weight loss is complex and likely bidirectional. While taste alterations may contribute to weight loss, the weight loss itself and associated metabolic changes could also influence taste perception [23].
Nutrition counseling before bariatric surgery is crucial as it enhances weight loss outcomes [24,25]. Given the prevalence and potential impact of changes in the perception of taste after bariatric surgery, it is crucial to address this topic during preoperative patient counseling:
1. Setting realistic expectations: Informing patients about potential changes in their perception of taste can help set realistic expectations for their postoperative experience. This knowledge can prepare patients for the possibility of altered food preferences and help them navigate the psychological aspects of these changes.
2. Nutritional guidance: Understanding potential changes in taste perception can inform tailored nutritional guidance. For example, patients should be made aware that they may experience reduced preference for protein-rich foods postoperatively and may need strategies to ensure adequate protein intake.
3. Improving adherence: Awareness of potential changes in taste perception may improve adherence to postoperative dietary recommendations. Patients who understand that their taste preferences may shift might be more open to trying new, healthier food options.
4. Identifying potential risks: In rare cases, extreme taste aversions can lead to nutritional deficiencies or disordered eating patterns. Preoperative counseling can help identify patients who might be at higher risk for these complications and ensure appropriate postoperative monitoring.
Changes in the patient’s perception of taste are common and significant consequences of bariatric surgery, with potential impacts on eating behavior, weight loss outcomes, and quality of life. While the exact mechanisms underlying these changes are still being elucidated, alterations in gut hormones, neural pathways, and the gut microbiome likely play important roles.
The relationship between taste changes and weight loss outcomes is complex, but it is reasonable to assume that altered taste perception may contribute to reduced calorie intake and modified food choices.
Incorporating discussions about potential changes into the patient’s perception of taste into perioperative counseling is crucial for setting realistic expectations and providing tailored nutritional guidance. Future research should focus on improving our understanding of the long-term trajectory of changes in taste perception after different bariatric procedures and their impact on weight loss maintenance and nutritional status.
As our understanding of taste perception after bariatric surgery continues to evolve, it will be important to refine patient education and postoperative care strategies to optimize outcomes and improve the overall patient experience.
None.
Fig. 1
Roux-en-Y gastric bypass.
acnm-16-3-120-f1.jpg
Fig. 2
Sleeve gastrectomy.
acnm-16-3-120-f2.jpg
Table 1
Potential mechanisms underlying changes in taste perception after bariatric surgery
Potential mechanisms Summary References
Alterations in gut hormones Bariatric procedures alter gut hormone secretion, including GLP-1, PYY, and ghrelin, impacting appetite and taste perception [12,13]
Neural pathway modifications Vagus nerve and other neural pathways involved in taste perception may be affected, leading to changes in taste sensitivity and preferences [14-16]
Changes in gut microbiome Shifts in oral and gut microbiota composition after surgery can impact taste perception and influence dietary habits [17,19,20]

GLP-1 = glucagon-like peptide-1; PYY = peptide YY.

  • 1. Bueter M, Miras AD, Chichger H, Fenske W, Ghatei MA, Bloom SR, et al. Alterations of sucrose preference after Roux-en-Y gastric bypass. Physiol Behav 2011;104:709-21. ArticlePubMed
  • 2. Behary P, Miras AD. Food preferences and underlying mechanisms after bariatric surgery. Proc Nutr Soc 2015;74:419-25. ArticlePubMed
  • 3. Miras AD, le Roux CW. Mechanisms underlying weight loss after bariatric surgery. Nat Rev Gastroenterol Hepatol 2013;10:575-84. ArticlePubMedPDF
  • 4. Mozaffar B, Mozaffar H, Alkharaiji M, Elbahrawy A, Idris I. Associations between zinc deficiency, taste changes, and salivary flow rates following gastric bypass and sleeve gastrectomy surgeries. J Nutr Metab 2024;2024:1197571. ArticlePubMedPMCPDF
  • 5. Walmsley R, Chong L, Hii MW, Brown RM, Sumithran P. 2024;The effect of bariatric surgery on the expression of gastrointestinal taste receptors: a systematic review. Rev Endocr Metab Disord 25:421-46. ArticlePubMedPMCPDF
  • 6. Van Vuuren MAJ, Strodl E, White KM, Lockie PD. Taste, enjoyment, and desire of flavors change after sleeve gastrectomy-short term results. Obes Surg 2017;27:1466-73. ArticlePubMedPDF
  • 7. Miras AD, Jackson RN, Jackson SN, Goldstone AP, Olbers T, Hackenberg T, et al. Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. Am J Clin Nutr 2012;96:467-73. ArticlePubMed
  • 8. Mathes CM, Spector AC. Food selection and taste changes in humans after Roux-en-Y gastric bypass surgery: a direct-measures approach. Physiol Behav 2012;107:476-83. ArticlePubMed
  • 9. Smith KR, Aghababian A, Papantoni A, Veldhuizen MG, Kamath V, Harris C, et al. One year follow-up of taste-related reward associations with weight loss suggests a critical time to mitigate weight regain following bariatric surgery. Nutrients 2021;13:3943.ArticlePubMedPMC
  • 10. Schiavo L, Aliberti SM, Calabrese P, Senatore AM, Severino L, Sarno G, et al. Changes in food choice, taste, desire, and enjoyment 1 year after sleeve gastrectomy: a prospective study. Nutrients 2022;14:2060.ArticlePubMedPMC
  • 11. Nance K, Acevedo MB, Pepino MY. Changes in taste function and ingestive behavior following bariatric surgery. Appetite 2020;146:104423. ArticlePubMedPMC
  • 12. Beckman LM, Beckman TR, Earthman CP. 2010;Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass procedure: a review. J Am Diet Assoc 110:571-84. ArticlePubMedPMC
  • 13. Martin B, Dotson CD, Shin YK, Ji S, Drucker DJ, Maudsley S, et al. Modulation of taste sensitivity by GLP-1 signaling in taste buds. Ann N Y Acad Sci 2009;1170:98-101. ArticlePubMedPMC
  • 14. Berthoud HR. Vagal and hormonal gut-brain communication: from satiation to satisfaction. Neurogastroenterol Motil 2008;20 Suppl 1:64-72. ArticlePubMedPMC
  • 15. Sperling W, Biermann T, Spannenberger R, Clepce M, Padberg F, Reulbach U, et al. Changes in gustatory perceptions of patients with major depression treated with vagus nerve stimulation (VNS). Pharmacopsychiatry 2011;44:67-71. ArticlePubMed
  • 16. Felizardo R, Boucher Y, Braud A, Carstens E, Dauvergne C, Zerari-Mailly F. Trigeminal projections on gustatory neurons of the nucleus of the solitary tract: a double-label strategy using electrical stimulation of the chorda tympani and tracer injection in the lingual nerve. Brain Res 2009;1288:60-8. ArticlePubMed
  • 17. Schamarek I, Anders L, Chakaroun RM, Kovacs P, Rohde-Zimmermann K. The role of the oral microbiome in obesity and metabolic disease: potential systemic implications and effects on taste perception. Nutr J 2023;22:28.ArticlePubMedPMCPDF
  • 18. Adawi H, Aggarwal A, Jain S, Othman MA, Othman AAA, Zakri RA, et al. Influence of bariatric surgery on oral microbiota: a systematic review. Eur J Dent 2023;17:602-14. ArticlePubMedPMC
  • 19. Gardner A, So PW, Carpenter GH. Intraoral microbial metabolism and association with host taste perception. J Dent Res 2020;99:739-45. ArticlePubMedPMCPDF
  • 20. Cattaneo C, Riso P, Laureati M, Gargari G, Pagliarini E. Exploring associations between interindividual differences in taste perception, oral microbiota composition, and reported food intake. Nutrients 2019;11:1167.ArticlePubMedPMC
  • 21. Berthoud HR, Zheng H. Modulation of taste responsiveness and food preference by obesity and weight loss. Physiol Behav 2012;107:527-32. ArticlePubMedPMC
  • 22. Smith KR, Papantoni A, Veldhuizen MG, Kamath V, Harris C, Moran TH, et al. Taste-related reward is associated with weight loss following bariatric surgery. J Clin Invest 2020;130:4370-81. ArticlePubMedPMC
  • 23. Fathi M, Javid AZ, Mansoori A. Effects of weight change on taste function; a systematic review. Nutr J 2023;22:22.ArticlePubMedPMCPDF
  • 24. Gradaschi R, Molinari V, Sukkar SG, De Negri P, Adami GF, Camerini G. Effects of the postoepartive dietetic/behavioral counseling on the weight loss after bariatric surgery. Obes Surg 2020;30:244-8. ArticlePubMedPDF
  • 25. Koffman L, Levis AW, Haneuse S, Johnson E, Bock S, McSperitt D, et al. Evaluation of intensive telephonic nutritional and lifestyle counseling to enhance outcomes of bariatric surgery. Obes Surg 2022;32:133-41. ArticlePubMedPDF

Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  

      • ePub LinkePub Link
      • Cite
        CITE
        export Copy Download
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Changes in perceptions of taste after bariatric surgery: a narrative review
        Ann Clin Nutr Metab. 2024;16(3):120-124.   Published online December 1, 2024
        DOI: https://doi.org/10.15747/ACNM.2024.16.3.120
        Close
      • XML DownloadXML Download
      Figure
      • 0
      • 1
      Related articles
      Changes in perceptions of taste after bariatric surgery: a narrative review
      Image Image
      Fig. 1 Roux-en-Y gastric bypass.
      Fig. 2 Sleeve gastrectomy.

      Fig. 1

      Fig. 2

      Changes in perceptions of taste after bariatric surgery: a narrative review

      Potential mechanisms underlying changes in taste perception after bariatric surgery

      Potential mechanisms Summary References
      Alterations in gut hormones Bariatric procedures alter gut hormone secretion, including GLP-1, PYY, and ghrelin, impacting appetite and taste perception [12,13]
      Neural pathway modifications Vagus nerve and other neural pathways involved in taste perception may be affected, leading to changes in taste sensitivity and preferences [14-16]
      Changes in gut microbiome Shifts in oral and gut microbiota composition after surgery can impact taste perception and influence dietary habits [17,19,20]

      GLP-1 = glucagon-like peptide-1; PYY = peptide YY.
      Table 1 Potential mechanisms underlying changes in taste perception after bariatric surgery

      GLP-1 = glucagon-like peptide-1; PYY = peptide YY.

      Table 1

      Ann Clin Nutr Metab : Annals of Clinical Nutrition and Metabolism
      © The Korean Society of Surgical Metabolism and Nutrition · The Korean Society for Parenteral and Enteral Nutrition · Asian Society of Surgical Metabolism and Nutrition.
      Close layer
      TOP