An investigation of the neural mechanisms underlying the efficacy of the adjustable gastric band

Stefanidis, Aneta; Forrest, Neal; Brown, Wendy A.; Dixon, John; O'Brien, PE; Kampe, Juliane; Oldfield, Brian J.

doi:10.1016/j.soard.2015.11.020

Cited by 17 publications

(8 citation statements)

References 30 publications

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“…This procedure was originally thought to physically restrict meal size and delay emptying of food from the pouch, thus producing early and prolonged satiety (20). However, much of the effect of the procedure is now thought to be provoked by pressure applied on the Intraganglionic Laminar Endings (IGLES) which relay afferent signals resulting in reductions in hunger (286). The gastric BAND causes a delayed bolus transit into the infraband stomach but does not change overall gastric emptying half-time, a key observation in relation to the differential effect of BAND versus RYGB on satiety, a topic developed in detail later in this manuscript (41).…”

Section: A Surgical Modalitiesmentioning

confidence: 99%

Food Intake and Eating Behavior After Bariatric Surgery

Al‐Najim

Docherty

Roux

2018

Physiological Reviews

142

109

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Obesity is an escalating global chronic disease. Bariatric surgery is a very efficacious treatment for obesity and its comorbidities. Alterations to gastrointestinal anatomy during bariatric surgery result in neurological and physiological changes affecting hypothalamic signaling, gut hormones, bile acids, and gut microbiota, which coalesce to exert a profound influence on eating behavior. A thorough understanding of the mechanisms underlying eating behavior is essential in the management of patients after bariatric surgery. Studies investigating candidate mechanisms have expanded dramatically in the last decade. Herein we review the proposed mechanisms governing changes in eating behavior, food intake, and body weight after bariatric surgery. Additive or synergistic effects of both conditioned and unconditioned factors likely account for the complete picture of changes in eating behavior. Considered application of strategies designed to support the underlying principles governing changes in eating behavior holds promise as a means of optimizing responses to surgery and long-term outcomes.

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Section: A Surgical Modalitiesmentioning

confidence: 99%

Food Intake and Eating Behavior After Bariatric Surgery

Al‐Najim

Docherty

Roux

2018

Physiological Reviews

142

109

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“…By contrast, SG only damages terminal gastric vagal branches which oppositely results in increased density of vagal afferent in the NTS and the number of synapses, which has been suggested to be linked to higher sensitivity to nutrients and satiety feelings, and then to lower food intake (95). The fact that blocking of vagal afferent fibers in the band site abolishes AGB effects on food intake and satiety, highlights the role of vagal afferent pathways in mediating AGB effects likely by means of mechanoreception (97). Evidence from human studies dealing with the involvement of vagal system in BS effects are limited.…”

Section: Effects Of Bs On Glycemic Profile and Mechanisms Involved Inmentioning

confidence: 99%

Metabolic and Endocrine Consequences of Bariatric Surgery

2019

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Obesity is one of the most serious worldwide epidemics of the twenty-first century according to the World Health Organization. Frequently associated with a number of comorbidities, obesity threatens and compromises individual health and quality of life. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss. The beneficial effects of BS on metabolic traits are so widely recognized that some authors have proposed BS as metabolic surgery that could be prescribed even for moderate obesity. However, most of the BS procedures imply malabsorption and/or gastric acid reduction which lead to nutrient deficiency and, consequently, further complications could be developed in the long term. In fact, BS not only affects metabolic homeostasis but also has pronounced effects on endocrine systems other than those exclusively involved in metabolic function. The somatotropic, corticotropic, and gonadal axes as well as bone health have also been shown to be affected by the various BS procedures. Accordingly, further consequences and complications of BS in the long term in systems other than metabolic system need to be addressed in large cohorts, taking into account each bariatric procedure before making generalized recommendations for BS. In this review, current data regarding these issues are summarized, paying special attention to the somatotropic, corticotropic, gonadal axes, and bone post-operative health.

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“…This hypothesis was proven by Kampe et al , who revealed that the gastric band exerts its effect via the stimulation of vagal afferents in a rat model. Similarly, Stefanidis et al found that the expected decreases of food consumption, body weight, and adipose tissue mass after AGB were attenuated in vagal sensory‐lesioned rats pretreated by capsaicin. Some human studies, however, have observed that patients treated by AGB with or without truncal vagotomy presented comparable EWL, although truncal vagotomy resulted in less hunger compared with AGB alone .…”

Section: Mechanisms Of Weight Lossmentioning

confidence: 84%

Mechanisms of Weight Loss After Sleeve Gastrectomy and Adjustable Gastric Banding: Far More Than Just Restriction

Wang

Guo

et al. 2019

Obesity

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Obesity has reached global epidemic proportions in recent decades. Bariatric surgery is currently accepted as most effective in alleviating morbid obesity and related disorders. Sleeve gastrectomy (SG) and adjustable gastric banding (AGB) have gained popularity since the beginning of this century because of their efficacy, safety, and simplicity. SG, in particular, has emerged as the most popular bariatric procedure because of its simpler concept and shorter operative time compared with gastric bypass. Caloric restriction, however, cannot account for the sustained weight loss and improved glucose metabolism seen following SG and AGB. Other mechanisms, including changes in gastrointestinal hormone secretion, rearrangement of hypothalamic and vagal control, alteration in energy expenditure, and re‐regulation of bile acid metabolism and the intestinal flora environment, are thought to contribute to the postoperative benefits. This review focuses on clinical and experimental literature addressing the potential mechanisms for SG and AGB procedures in human and animal models. Understanding such mechanisms can provide important insight into how current gastric restrictive procedures work and how future treatments of obesity, both surgical and nonsurgical, can be developed.

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An investigation of the neural mechanisms underlying the efficacy of the adjustable gastric band

Cited by 17 publications

References 30 publications

Food Intake and Eating Behavior After Bariatric Surgery

Food Intake and Eating Behavior After Bariatric Surgery

Metabolic and Endocrine Consequences of Bariatric Surgery

Mechanisms of Weight Loss After Sleeve Gastrectomy and Adjustable Gastric Banding: Far More Than Just Restriction

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