The effect of adding a subtotal gastrectomy to a laparoscopic gastric bypass procedure on striatal D2/D3 receptor availability. A single-blinded, randomized, single-center study

INTERVENTION: LRYGB vs. LRYGB+subtotal gastrectomy (LRYGB+) CONDITION: Obesity ; ; PRIMARY OUTCOME: Striatal D2/D3 receptor availability and dopamine release as well as whole brain (serotonergic) activity, including the response to visual food stimuli. SECONDARY OUTCOME: Aspects of motivation and impulse control of feeding behaviour (questionnaires, tasks and phMRI) ; ; Assessment of craving and hunger (questionnaires) ; ; Fasting and postprandial acylated ghrelin (IGTT) ; ; Glucose metabolism (IGTT) ; ; Gut hormones, free fatty acids ; ; Body weight loss ; ; Feelings of craving and hunger (Questionnaires) ; ; Food addiction according to Yale Food Addiction scale INCLUSION CRITERIA: Age 25‐65 years BMI > 45.0 kg/m2 at the start of the LRYGB trajectory (defined as the first visit to the surgery outpatient clinic of the Slotervaart hospital) Stable weight defined as not losing or gaining >5% of total body weight 4 weeks prior to inclusion ASA classification1‐2 Written informed consent