Lipid and Metabolic Effects of Gastrointestinal Surgery (F Rubino, Section Editor)

Current Atherosclerosis Reports

, Volume 14, Issue 6, pp 616-623

First online:

Mechanisms of Weight Loss, Diabetes Control and Changes in Food Choices After Gastrointestinal Surgery

  • Dimitrios PapamargaritisAffiliated withImperial Weight Centre, Imperial College London
  • , Eleftheria PanteliouAffiliated withRoyal London Hospital
  • , Alexander D. MirasAffiliated withImperial Weight Centre, Imperial College LondonMolecular and Metabolic Imaging Group, MRC Clinical Sciences Centre, Imperial College
  • , Carel W. le RouxAffiliated withImperial Weight Centre, Imperial College LondonConway Institute, School of Medicine and Medical Sciences, University College Email author 

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The long-term effects of lifestyle changes, diet and medical therapy on obesity are limited. Bariatric surgery is the most effective long-term treatment with the greatest chances for amelioration of obesity-associated complications, including type 2 diabetes mellitus (T2DM). There is increasing evidence in the literature that bariatric operations have a profound effect on human physiology, by reducing hunger, increasing satiety, paradoxically increasing energy expenditure, and even promoting healthy food preferences. Some of these operations improve glucose homeostasis in patients with T2DM independently of weight loss. Changes in the gut hormone levels of glucagon-like peptide 1, peptide YY and ghrelin have been proposed as some of the mediators implicated in changing physiology. The aim of this review is to critically explore the current knowledge on the putative mechanisms of the change in weight and improvement in T2DM glycaemic control after the most commonly performed bariatric operations.


Gut hormones Energy expenditure Food preferences Taste