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Review
. 2025 Aug 12:19:1654559.
doi: 10.3389/fnins.2025.1654559. eCollection 2025.

Affective-cognitive circuits in postoperative appetite reduction: an adaptive neuroimmune response to surgical stress

Yanbo Sun #  1   2   3 , Xianrong Bao #  2 , Yunyun Cen  2 , Huiyin Wu  1 , Feng Sun  2 , Lin Fu  1   4
Affiliations
Review

Affective-cognitive circuits in postoperative appetite reduction: an adaptive neuroimmune response to surgical stress

Yanbo Sun et al. Front Neurosci. .

Abstract

Postoperative reduction in appetite perception, conceptualized as an interplay between emotion, perception, and cognition, may lead to adverse nutritional outcomes. However, an increasing body of research suggests that it may serve as an adaptive mechanism to inhibit inflammatory responses and regulate metabolic burden. This review comprehensively summarizes the multifaceted mechanisms underlying postoperative changes in appetite perception, particularly from the perspectives of immune regulation, inflammatory suppression, and metabolic reprogramming. Special attention is paid to the affective and cognitive dimensions of appetite perception, exploring how emotion-related processing and neurocognitive feedback contribute to appetite perception suppression during recovery. Moreover, this review highlights the clinical significance of these affective-perceptual changes in postoperative nutritional management, emphasizing the need to integrate psychological, perceptual, and neuroimmune factors into patient care strategies. Ultimately, the article explores the potential role of postoperative appetite perception reduction in modulating insulin sensitivity and improving systemic metabolic health. Based on current literature, we advocate for reevaluating appetite perception dynamics during recovery to provide novel theoretical foundations and practical directions for targeted postoperative nutritional interventions.

Keywords: appetite perception; feeding behavior; inflammatory responses; neuroimmune factors; postoperative.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The anti-inflammatory mechanism of postoperative appetite reduction. (a) Low nutritional status suppresses the mitochondrial function of immune cells and glycolytic pathways. (b) Adipose tissue is both a core organ for energy storage and a key hub for regulating systemic metabolism and immune balance. (c) The pathological coupling of postoperative low metabolism and skeletal muscle consumption is key to patient recovery. (d) Gastrointestinal hormones such as Ghrelin, GLP-1, and PYY in appetite perception regulation and inflammatory responses. (e) The HPA axis plays a central role in postoperative metabolic and immune homeostasis through dual regulatory mechanisms. HPA, the hypothalamic pituitary adrenal; M, Macrophages; MEU, Neutrophils.
Figure 2
Figure 2
The anti-inflammatory mechanism of low nutrient intake.
See this image and copyright information in PMC

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