"The stomach I have now has a brain connection:" changes in experiences of hunger and fullness following bariatric surgery.

ABSTRACT

The rate of obesity in the U.S. is at an all-time high of 42.4%, with 9.2% of cases falling in the severe obesity category. Bariatric surgery results in significant weight loss through two of the most popular options, sleeve gastrectomy and Roux-en-Y gastric bypass. One of the mechanisms through which these surgeries work is via the alteration of neural and hormonal appetite signaling, which leads to decreases in hunger and increases in fullness. The available measures for assessing hunger and fullness were not developed for use in bariatric surgery patients and do not capture physical hunger feelings or normal fullness. A longitudinal mixed-method study of 30 bariatric surgery patients (20% male, 20% African American) was designed to explore the physical and psychological feelings associated with hunger and fullness. Participants were recruited from an accredited bariatric surgery center and interviewed prior to surgery and 6 and 12-months after surgery. Transcripts were coded using a constant comparative method. Themes were created using a grounded theory approach. Different pathways were discovered such that participants' experiences of hunger and fullness varied compared to each other, as well as over time. Hunger had physical and psychological qualities, whereas fullness was generally only described as being physical. These results suggest that pre-surgery and post-surgery counseling should be customized in regard to appetite. Measures should be developed to better capture the true experiences of hunger and fullness among bariatric surgery patients.