Weight Loss Surgery and the Development of Addictive Disorders

July 2018

Obesity is a worldwide epidemic, costing millions of lives and billions of dollars annually. It is a chronic disease that has proven to be extremely difficult to treat, due to the multifactorial nature of its etiology. An increased understanding of etiological mechanisms is critical to the development of more effective obesity prevention and treatment strategies. One promising avenue for this endeavor is emerging evidence regarding connections between obesity and addiction. A growing body of evidence suggests parallels, and shared physiological and neural pathways, between these two conditions. A greater understanding of these connections promises insights likely to enhance efforts to understand and treat both conditions. Relevant to these parallels, there is growing evidence that weight loss surgery (WLS) causes changes in behaviors and brain pathways that are relevant to both obesity and addiction, and several studies have found elevated rates of post-operative substance abuse, including a substantial proportion of new onset cases. Thus, WLS provides a particularly interesting avenue for examining the connections between obesity and addiction. In 2012, our group convened a Radcliffe Exploratory Seminar, bringing together researchers working in domains relevant to the intersection between obesity and addiction. This meeting allowed the first steps of synthesis of varying lines of research and some new pathways toward a more integrated program of investigation. A synthesis paper resulted, now awaiting publication, and participants have continued their individual research in these areas. We are now in a good place to convene an Advanced Seminar, with a narrower focus, to further hone our investigation. The resulting collaboration would allow us to produce a number of tangible outcomes: Writing additional manuscripts; designing longitudinal and experimental research protocols; developing a centralized research database; and creating of a set of educational materials for healthcare providers and patients to aid in collaborative, patient-centered treatment planning and decision-making.