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Underlying Physiological Mechanisms of Bariatric Surgery

  • Chapter
Obesity

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Abstract

Obesity is detrimental to health and challenges public health systems worldwide. Bariatric surgery to date is the best method not only to reduce, but also maintain body weight loss in the long-term. Further, bariatric surgery reduces obesity-associated morbidity and is the only method so far with a proven mortality benefit [1–4].

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References

  1. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  2. Carlsson LM, Peltonen M, Ahlin S, et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med. 2012;367(8):695–704.

    Article  CAS  PubMed  Google Scholar 

  3. Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.

    Article  CAS  PubMed  Google Scholar 

  4. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg. 2009;19(12):1605–11.

    Article  PubMed  Google Scholar 

  6. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962–9.

    Article  PubMed  Google Scholar 

  7. Weber M, Muller MK, Bucher T, et al. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004;240(6):975–82; discussion 982–3.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg. 2007;17(2):260–70.

    Article  PubMed  Google Scholar 

  9. le Roux CW, Aylwin SJ, Batterham RL, et al. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg. 2006;243(1):108–14.

    Article  PubMed Central  PubMed  Google Scholar 

  10. le Roux CW, Welbourn R, Werling M, et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann Surg. 2007;246(5):780–5.

    Article  PubMed  Google Scholar 

  11. Bueter M, Miras AD, Chichger H, et al. Alterations of sucrose preference after Roux-en-Y gastric bypass. Physiol Behav. 2011;104(5):709–21.

    Article  CAS  PubMed  Google Scholar 

  12. le Roux CW, Bueter M, Theis N, et al. Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol. 2011;301(4):R1057–66.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  13. Stylopoulos N, Hoppin AG, Kaplan LM. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring). 2009;17(10):1839–47.

    Article  Google Scholar 

  14. Bueter M, Lowenstein C, Olbers T, et al. Gastric bypass increases energy expenditure in rats. Gastroenterology. 2010;138(5):1845–53.

    Article  PubMed  Google Scholar 

  15. Ochner CN, Kwok Y, Conceicao E, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg. 2011;253(3):502–7.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Borg CM, le Roux CW, Ghatei MA, et al. Progressive rise in gut hormone levels after Roux-en-Y gastric bypass suggests gut adaptation and explains altered satiety. Br J Surg. 2006;93(2):210–5.

    Article  CAS  PubMed  Google Scholar 

  17. Naslund E, Gryback P, Hellstrom PM, et al. Gastrointestinal hormones and gastric emptying 20 years after jejunoileal bypass for massive obesity. Int J Obes Relat Metab Disord. 1997;21(5):387–92.

    Article  CAS  PubMed  Google Scholar 

  18. Ashrafian H, le Roux CW. Metabolic surgery and gut hormones – a review of bariatric entero-humoral modulation. Physiol Behav. 2009;97(5):620–31.

    Article  CAS  PubMed  Google Scholar 

  19. Dutia R, Embrey M, O’Brien S, et al. Temporal changes in bile acid levels and 12alpha-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond). 2015;39(5):806–13.

    Article  CAS  Google Scholar 

  20. Werling M, Vincent RP, Cross GF, et al. Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery. Scand J Gastroenterol. 2013;48(11):1257–64.

    Article  PubMed  Google Scholar 

  21. Zheng H, Shin AC, Lenard NR, et al. Meal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery. Am J Physiol Regul Integr Comp Physiol. 2009;297(5):R1273–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Olbers T, Bjorkman S, Lindroos A, et al. Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg. 2006;244(5):715–22.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Babic T, Townsend RL, Patterson LM, et al. Phenotype of neurons in the nucleus of the solitary tract that express CCK-induced activation of the ERK signaling pathway. Am J Physiol Regul Integr Comp Physiol. 2009;296(4):R845–54.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. He B, Chen L, Yu C, et al. Roux-en-Y gastric bypass increases hepatic and peripheral insulin sensitivity in rats with type 2 diabetes mellitus. Surg Obes Relat Dis. 2014;10(3):485–93.

    Article  PubMed  Google Scholar 

  25. He B, Piao D, Yu C, et al. Amelioration in hepatic insulin sensitivity by reduced hepatic lipid accumulation at short-term after Roux-en-Y gastric bypass surgery in type 2 diabetic rats. Obes Surg. 2013;23(12):2033–41.

    Article  PubMed  Google Scholar 

  26. Peng Y, Rideout DA, Rakita SS, et al. Does LKB1 mediate activation of hepatic AMP-protein kinase (AMPK) and sirtuin1 (SIRT1) after Roux-en-Y gastric bypass in obese rats? J Gastrointest Surg. 2010;14(2):221–8.

    Article  PubMed  Google Scholar 

  27. Peng Y, Murr MM. Roux-en-Y gastric bypass improves hepatic mitochondrial function in obese rats. Surg Obes Relat Dis. 2013;9(3):429–35.

    Article  PubMed  Google Scholar 

  28. Abegg K, Schiesser M, Lutz TA, et al. Acute peripheral GLP-1 receptor agonism or antagonism does not alter energy expenditure in rats after Roux-en-Y gastric bypass. Physiol Behav. 2013;121:70–8.

    Article  CAS  PubMed  Google Scholar 

  29. Stemmer K, Bielohuby M, Grayson BE, et al. Roux-en-Y gastric bypass surgery but not vertical sleeve gastrectomy decreases bone mass in male rats. Endocrinology. 2013;154(6):2015–24.

    Article  CAS  PubMed  Google Scholar 

  30. Stefater MA, Wilson-Perez HE, Chambers AP, et al. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012;33(4):595–622.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Mumphrey MB, Patterson LM, Zheng H, et al. Roux-en-Y gastric bypass surgery increases number but not density of CCK-, GLP-1-, 5-HT-, and neurotensin-expressing enteroendocrine cells in rats. Neurogastroenterol Motil. 2013;25(1):e70–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Taqi E, Wallace LE, de Heuvel E, et al. The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model. J Pediatr Surg. 2010;45(5):987–95.

    Article  PubMed  Google Scholar 

  33. Bueter M, Abegg K, Seyfried F, et al. Roux-en-Y gastric bypass operation in rats. J Vis Exp. 2012;64:e3940.

    PubMed  Google Scholar 

  34. Laurenius A, Larsson I, Bueter M, et al. Changes in eating behaviour and meal pattern following Roux-en-Y gastric bypass. Int J Obes (Lond). 2012;36(3):348–55.

    Article  CAS  Google Scholar 

  35. Lutz TA, Bueter M. Physiological mechanisms behind Roux-en-Y gastric bypass surgery. Dig Surg. 2014;31(1):13–24.

    Article  PubMed  Google Scholar 

  36. Seyfried F, Lannoo M, Gsell W, et al. Roux-en-Y gastric bypass in mice–surgical technique and characterisation. Obes Surg. 2012;22(7):1117–25.

    Article  CAS  PubMed  Google Scholar 

  37. Dirksen C, Jorgensen NB, Bojsen-Moller KN, et al. Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass. Int J Obes (Lond). 2013;37(11):1452–9.

    Article  CAS  Google Scholar 

  38. Chambers AP, Smith EP, Begg DP, et al. Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab. 2014;306(4):E424–32.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Bjorklund P, Laurenius A, Een E, et al. Is the Roux limb a determinant for meal size after gastric bypass surgery? Obes Surg. 2010;20(10):1408–14.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Bueter M, Lowenstein C, Ashrafian H, et al. Vagal sparing surgical technique but not stoma size affects body weight loss in rodent model of gastric bypass. Obes Surg. 2010;20(5):616–22.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Kinzig KP, D’Alessio DA, Seeley RJ. The diverse roles of specific GLP-1 receptors in the control of food intake and the response to visceral illness. J Neurosci. 2002;22(23):10470–6.

    CAS  PubMed  Google Scholar 

  42. Halatchev IG, Cone RD. Peripheral administration of PYY(3-36) produces conditioned taste aversion in mice. Cell Metab. 2005;1(3):159–68.

    Article  CAS  PubMed  Google Scholar 

  43. Seyfried F, Miras AD, Bueter M, et al. Effects of preoperative exposure to a high-fat versus a low-fat diet on ingestive behavior after gastric bypass surgery in rats. Surg Endosc. 2013;27(11):4192–201.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Shin AC, Zheng H, Berthoud HR. Vagal innervation of the hepatic portal vein and liver is not necessary for Roux-en-Y gastric bypass surgery-induced hypophagia, weight loss, and hypermetabolism. Ann Surg. 2012;255(2):294–301.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Saeidi N, Nestoridi E, Kucharczyk J, et al. Sleeve gastrectomy and Roux-en-Y gastric bypass exhibit differential effects on food preferences, nutrient absorption and energy expenditure in obese rats. Int J Obes (Lond). 2012;36(11):1396–402.

    Article  CAS  Google Scholar 

  46. Stefater MA, Perez-Tilve D, Chambers AP, et al. Sleeve gastrectomy induces loss of weight and fat mass in obese rats, but does not affect leptin sensitivity. Gastroenterology. 2010;138(7):2426–36, 2436.e1–3.

    Google Scholar 

  47. Shibata H, Bukowiecki LJ. Regulatory alterations of daily energy expenditure induced by fasting or overfeeding in unrestrained rats. J Appl Physiol (1985). 1987;63(2):465–70.

    Google Scholar 

  48. Werling M, Olbers T, Fandriks L, et al. Increased postprandial energy expenditure may explain superior long term weight loss after Roux-en-Y gastric bypass compared to vertical banded gastroplasty. PLoS One. 2013;8(4):e60280.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Foster DO, Frydman ML. Tissue distribution of cold-induced thermogenesis in conscious warm- or cold-acclimated rats reevaluated from changes in tissue blood flow: the dominant role of brown adipose tissue in the replacement of shivering by nonshivering thermogenesis. Can J Physiol Pharmacol. 1979;57(3):257–70.

    Article  CAS  PubMed  Google Scholar 

  50. Cant JP, McBride BW, Croom Jr WJ. The regulation of intestinal metabolism and its impact on whole animal energetics. J Anim Sci. 1996;74(10):2541–53.

    CAS  PubMed  Google Scholar 

  51. Saeidi N, Meoli L, Nestoridi E, et al. Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science. 2013;341(6144):406–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Carrasco F, Papapietro K, Csendes A, et al. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obes Surg. 2007;17(5):608–16.

    Article  PubMed  Google Scholar 

  53. Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;78(1):22–30.

    CAS  PubMed  Google Scholar 

  54. Thivel D, Brakonieki K, Duche P, et al. Surgical weight loss: impact on energy expenditure. Obes Surg. 2013;23(2):255–66.

    Article  PubMed  Google Scholar 

  55. Thivel D, Chaput JP, Adamo KB, et al. Is energy intake altered by a 10-week aerobic exercise intervention in obese adolescents? Physiol Behav. 2014;135:130–4.

    Article  CAS  PubMed  Google Scholar 

  56. Hajnal A, Kovacs P, Ahmed T, et al. Gastric bypass surgery alters behavioral and neural taste functions for sweet taste in obese rats. Am J Physiol Gastrointest Liver Physiol. 2010;299(4):G967–79.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  57. Pepino MY, Bradley D, Eagon JC, et al. Changes in taste perception and eating behavior after bariatric surgery-induced weight loss in women. Obesity (Silver Spring). 2014;22(5):E13–20.

    Article  Google Scholar 

  58. Shin AC, Zheng H, Pistell PJ, et al. Roux-en-Y gastric bypass surgery changes food reward in rats. Int J Obes (Lond). 2011;35(5):642–51.

    Article  CAS  Google Scholar 

  59. Baik JH. Dopamine signaling in food addiction: role of dopamine D2 receptors. BMB Rep. 2013;46(11):519–26.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Ochner CN, Laferrere B, Afifi L, et al. Neural responsivity to food cues in fasted and fed states pre and post gastric bypass surgery. Neurosci Res. 2012;74(2):138–43.

    Article  PubMed Central  PubMed  Google Scholar 

  61. Ochner CN, Stice E, Hutchins E, et al. Relation between changes in neural responsivity and reductions in desire to eat high-calorie foods following gastric bypass surgery. Neuroscience. 2012;209:128–35.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  62. Scholtz S, Miras AD, Chhina N, et al. Obese patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding. Gut. 2014;63(6):891–902.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Miras AD, Jackson RN, Jackson SN, et al. Gastric bypass surgery for obesity decreases the reward value of a sweet-fat stimulus as assessed in a progressive ratio task. Am J Clin Nutr. 2012;96(3):467–73.

    Article  CAS  PubMed  Google Scholar 

  64. Atkinson RL, Brent EL. Appetite suppressant activity in plasma of rats after intestinal bypass surgery. Am J Physiol. 1982;243(1):R60–4.

    CAS  PubMed  Google Scholar 

  65. Fenske WK, Bueter M, Miras AD, et al. Exogenous peptide YY3-36 and Exendin-4 further decrease food intake, whereas octreotide increases food intake in rats after Roux-en-Y gastric bypass. Int J Obes (Lond). 2012;36(3):379–84.

    Article  CAS  Google Scholar 

  66. le Roux CW, Borg C, Wallis K, et al. Gut hypertrophy after gastric bypass is associated with increased glucagon-like peptide 2 and intestinal crypt cell proliferation. Ann Surg. 2010;252(1):50–6.

    Article  PubMed  Google Scholar 

  67. Shin AC, Pistell PJ, Phifer CB, et al. Reversible suppression of food reward behavior by chronic mu-opioid receptor antagonism in the nucleus accumbens. Neuroscience. 2010;170(2):580–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  68. Pournaras DJ, Osborne A, Hawkins SC, et al. The gut hormone response following Roux-en-Y gastric bypass: cross-sectional and prospective study. Obes Surg. 2010;20(1):56–60.

    Article  PubMed  Google Scholar 

  69. Chambers AP, Jessen L, Ryan KK, et al. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology. 2011;141(3):950–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  70. Chambers AP, Stefater MA, Wilson-Perez HE, et al. Similar effects of roux-en-Y gastric bypass and vertical sleeve gastrectomy on glucose regulation in rats. Physiol Behav. 2011;105(1):120–3.

    Article  CAS  PubMed  Google Scholar 

  71. le Roux CW, Patterson M, Vincent RP, et al. Postprandial plasma ghrelin is suppressed proportional to meal calorie content in normal-weight but not obese subjects. J Clin Endocrinol Metab. 2005;90(2):1068–71.

    Article  PubMed  CAS  Google Scholar 

  72. Beckman LM, Beckman TR, Sibley SD, et al. Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery. JPEN J Parenter Enteral Nutr. 2011;35(2):169–80.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  73. Chandarana K, Gelegen C, Karra E, et al. Diet and gastrointestinal bypass-induced weight loss: the roles of ghrelin and peptide YY. Diabetes. 2011;60(3):810–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  74. Asarian L, Abegg K, Geary N, et al. Estradiol increases body weight loss and gut-peptide satiation after Roux-en-Y gastric bypass in ovariectomized rats. Gastroenterology. 2012;143(2):325–7.e2.

    Article  CAS  PubMed  Google Scholar 

  75. Ye J, Hao Z, Mumphrey MB, et al. GLP-1 receptor signaling is not required for reduced body weight after RYGB in rodents. Am J Physiol Regul Integr Comp Physiol. 2014;306(5):R352–62.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  76. Wilson-Perez HE, Chambers AP, Ryan KK, et al. Vertical sleeve gastrectomy is effective in two genetic mouse models of glucagon-like Peptide 1 receptor deficiency. Diabetes. 2013;62(7):2380–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  77. Rubino F, Schauer PR, Kaplan LM, et al. Metabolic surgery to treat type 2 diabetes: clinical outcomes and mechanisms of action. Annu Rev Med. 2010;61:393–411.

    Article  CAS  PubMed  Google Scholar 

  78. Gaitonde S, Kohli R, Seeley R. The role of the gut hormone GLP-1 in the metabolic improvements caused by ileal transposition. J Surg Res. 2012;178(1):33–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  79. Jorgensen NB, Dirksen C, Bojsen-Moller KN, et al. Exaggerated glucagon-like peptide 1 response is important for improved beta-cell function and glucose tolerance after Roux-en-Y gastric bypass in patients with type 2 diabetes. Diabetes. 2013;62(9):3044–52.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  80. Shah M, Law JH, Micheletto F, et al. Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after Roux-en-Y gastric bypass. Diabetes. 2014;63(2):483–93.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  81. Jackness C, Karmally W, Febres G, et al. Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and beta-cell Function in type 2 diabetic patients. Diabetes. 2013;62(9):3027–32.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  82. Rocca AS, Brubaker PL. Role of the vagus nerve in mediating proximal nutrient-induced glucagon-like peptide-1 secretion. Endocrinology. 1999;140(4):1687–94.

    CAS  PubMed  Google Scholar 

  83. Parker HE, Wallis K, le Roux CW, et al. Molecular mechanisms underlying bile acid-stimulated glucagon-like peptide-1 secretion. Br J Pharmacol. 2012;165(2):414–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  84. Hansen CF, Bueter M, Theis N, et al. Hypertrophy dependent doubling of L-cells in Roux-en-Y gastric bypass operated rats. PLoS One. 2013;8(6):e65696.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  85. Ashrafian H, le Roux CW, Rowland SP, et al. Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012;67(5):442–9.

    Article  PubMed  Google Scholar 

  86. Pournaras DJ, Glicksman C, Vincent RP, et al. The role of bile after Roux-en-Y gastric bypass in promoting weight loss and improving glycaemic control. Endocrinology. 2012;153(8):3613–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  87. Ahmad NN, Pfalzer A, Kaplan LM. Roux-en-Y gastric bypass normalizes the blunted postprandial bile acid excursion associated with obesity. Int J Obes (Lond). 2013;37(12):1553–9.

    Article  CAS  Google Scholar 

  88. Watanabe M, Houten SM, Mataki C, et al. Bile acids induce energy expenditure by promoting intracellular thyroid hormone activation. Nature. 2006;439(7075):484–9.

    Article  CAS  PubMed  Google Scholar 

  89. Duboc H, Tache Y, Hofmann AF. The bile acid TGR5 membrane receptor: from basic research to clinical application. Dig Liver Dis. 2014;46(4):302–12.

    Article  CAS  PubMed  Google Scholar 

  90. Browning KN, Fortna SR, Hajnal A. Roux-en-Y gastric bypass reverses the effects of diet-induced obesity to inhibit the responsiveness of central vagal motoneurones. J Physiol. 2013;591(Pt 9):2357–72.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  91. Ryan KK, Kohli R, Gutierrez-Aguilar R, et al. Fibroblast growth factor-19 action in the brain reduces food intake and body weight and improves glucose tolerance in male rats. Endocrinology. 2013;154(1):9–15.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  92. Cani PD, Lecourt E, Dewulf EM, et al. Gut microbiota fermentation of prebiotics increases satietogenic and incretin gut peptide production with consequences for appetite sensation and glucose response after a meal. Am J Clin Nutr. 2009;90(5):1236–43.

    Article  CAS  PubMed  Google Scholar 

  93. de La Serre CB, Ellis CL, Lee J, et al. Propensity to high-fat diet-induced obesity in rats is associated with changes in the gut microbiota and gut inflammation. Am J Physiol Gastrointest Liver Physiol. 2010;299(2):G440–8.

    Article  CAS  Google Scholar 

  94. Li JV, Ashrafian H, Bueter M, et al. Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk. Gut. 2011;60(9):1214–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  95. Liou AP, Paziuk M, Luevano JM, Jr., et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med. 2013;5(178):178ra41.

    Google Scholar 

  96. Furet JP, Kong LC, Tap J, et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes. 2010;59(12):3049–57.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  97. Osto M, Abegg K, Bueter M, et al. Roux-en-Y gastric bypass surgery in rats alters gut microbiota profile along the intestine. Physiol Behav. 2013;119:92–6.

    Article  CAS  PubMed  Google Scholar 

  98. Sayin SI, Wahlstrom A, Felin J, et al. Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid, a naturally occurring FXR antagonist. Cell Metab. 2013;17(2):225–35.

    Article  CAS  PubMed  Google Scholar 

  99. Wang Y, Liu J. Combination of bypassing stomach and vagus dissection in high-fat diet-induced obese rats-a long-term investigation. Obes Surg. 2010;20(3):375–9.

    Article  PubMed  Google Scholar 

  100. Romanova IV, Ramos EJ, Xu Y, et al. Neurobiologic changes in the hypothalamus associated with weight loss after gastric bypass. J Am Coll Surg. 2004;199(6):887–95.

    Article  PubMed  Google Scholar 

  101. Mul JD, van Boxtel R, Bergen DJ, et al. Melanocortin receptor 4 deficiency affects body weight regulation, grooming behavior, and substrate preference in the rat. Obesity (Silver Spring). 2012;20(3):612–21.

    Article  CAS  Google Scholar 

  102. Aslan IR, Campos GM, Calton MA, et al. Weight loss after Roux-en-Y gastric bypass in obese patients heterozygous for MC4R mutations. Obes Surg. 2011;21(7):930–4.

    Article  PubMed Central  PubMed  Google Scholar 

  103. Hatoum IJ, Stylopoulos N, Vanhoose AM, et al. Melanocortin-4 receptor signaling is required for weight loss after gastric bypass surgery. J Clin Endocrinol Metab. 2012;97(6):E1023–31.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  104. Mirshahi UL, Still CD, Masker KK, et al. The MC4R(I251L) allele is associated with better metabolic status and more weight loss after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96(12):E2088–96.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  105. Valette M, Poitou C, Le Beyec J, et al. Melanocortin-4 receptor mutations and polymorphisms do not affect weight loss after bariatric surgery. PLoS One. 2012;7(11):e48221.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  106. Zechner JF, Mirshahi UL, Satapati S, et al. Weight-independent effects of roux-en-Y gastric bypass on glucose homeostasis via melanocortin-4 receptors in mice and humans. Gastroenterology. 2013;144(3):580–90.e7.

    Article  CAS  PubMed  Google Scholar 

  107. Mul JD, Begg DP, Alsters SI, et al. Effect of vertical sleeve gastrectomy in melanocortin receptor 4-deficient rats. Am J Physiol Endocrinol Metab. 2012;303(1):E103–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  108. Bueter M, Ashrafian H, le Roux CW. Mechanisms of weight loss after gastric bypass and gastric banding. Obes Facts. 2009;2(5):325–31.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Abdominal- and Transplant Surgery, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland

    Diana Vetter MD & Marco Bueter MD, PhD

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  1. Diana Vetter MD
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  2. Marco Bueter MD, PhD
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Correspondence to Marco Bueter MD, PhD .

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Editors and Affiliations

  1. School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom

    Shamim I. Ahmad

  2. Al Mouwasat Hospital, Jubail, Saudi Arabia

    Syed Khalid Imam

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Vetter, D., Bueter, M. (2016). Underlying Physiological Mechanisms of Bariatric Surgery. In: Ahmad, S., Imam, S. (eds) Obesity. Springer, Cham. https://doi.org/10.1007/978-3-319-19821-7_23

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  • DOI: https://doi.org/10.1007/978-3-319-19821-7_23

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19820-0

  • Online ISBN: 978-3-319-19821-7

  • eBook Packages: MedicineMedicine (R0)

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