Obesity and taste perception disorders: peripheral and central mechanisms of a bidirectional association (narrative review)

Obesity is a complex multifactorial chronic disease characterized by profound metabolic, endocrine, and behavioral alterations. Emerging evidence indicates that disturbances in taste perception may not only contribute to the development and maintenance of obesity but may also result from obesity-associated physiological changes. Consequently, the relationship between obesity and taste perception is increasingly recognized as bidirectional, involving intricate interactions between peripheral gustatory pathways and central neural mechanisms regulating food intake, reward processing, and energy homeostasis. This narrative review provides a comprehensive overview of current knowledge regarding the association between obesity and taste perception disorders. The physiological basis of taste perception, including the recognition of sweet, salty, sour, bitter, umami, and fat taste modalities, is examined. Particular attention is given to the impact of obesity-related chronic low-grade inflammation, hormonal and metabolic dysregulation, alterations in gut microbiota composition, and gut–brain axis signaling on taste receptor function, taste bud integrity, and sensory processing. In addition, genetic determinants of taste sensitivity and their potential influence on food preferences and eating behavior are discussed. The review also analyzes evidence demonstrating changes in taste perception following weight reduction, bariatric surgery, and treatment with glucagon-like peptide-1 receptor agonists. Accumulating data suggest that obesity-associated impairments in taste sensitivity may promote maladaptive eating behaviors and unfavorable dietary choices, thereby contributing to the persistence of excess body weight. Conversely, inherent variations in taste perception may influence susceptibility to increased energy intake and obesity development.  A deeper understanding of the mechanisms linking obesity and taste perception may improve obesity phenotyping and facilitate the development of personalized preventive and therapeutic strategies aimed at optimizing eating behavior and long-term metabolic outcomes. Keywords: obesity; taste perception; gustatory function; fat taste perception; eating behavior; reward processing; gut–brain axis; gut microbiota; glucagon-like peptide-1 receptor agonists; bariatric surgery.