Diet-induced thermogenesis and respiratory quotient after Roux-en-Y gastric bypass

Faria, Sílvia Leite; Faria, Orlando Pereira; Cardeal, Mariane de Almeida; Gouvêa, Heloisa Rodrigues de; Buffington, Cynthia

doi:10.1016/j.soard.2012.06.008

Cited by 34 publications

(31 citation statements)

References 27 publications

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Section: Energy Expendituresupporting

confidence: 77%

“…Considering the fact that RYGB rats increase their meal frequency compared with shamoperated or weight-matched rats (19, 132), the overall contribution of diet-induced thermogenesis may actually be higher in RYGB rats. Similar studies in respect to the role of postprandial energy expenditure after RYGB have recently been reported in a number of studies in human RYGB patients; postprandial energy expenditure was elevated compared with weight-matched control groups or compared with patients receiving vertical banded gastroplasty (40,152,153).In a recent study, brown adipose tissue activity (BAT) remained unaltered after RYGB, which is consistent with the lack of increased core body temperature (52). Further, we recently observed that the temperature measured directly in BAT did not differ between RYGB and sham rats, and that ␤-3 agonist-induced increases in BAT temperature were similar (unpublished results).…”

supporting

confidence: 70%

“…It is important to note, however, that the comparison to the weight-matched controls is always positive. In some, but not all, studies, the change in energy expenditure was paralleled by a lower respiratory quotient, indicating that fat oxidation is increased over carbohydrate oxidation (19,40,132). However, the latter may have been rather related to body weight loss than representing a specific surgical effect as body weight-matched sham-operated controls show a similar response.…”

Section: Energy Expenditurementioning

confidence: 97%

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The physiology underlying Roux-en-Y gastric bypass: a status report

Lutz

Bueter

2014

American Journal of Physiology-Regulatory, Integrative and Comp

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Lutz TA, Bueter M. The physiology underlying Roux-en-Y gastric bypass: a status report. Am J Physiol Regul Integr Comp Physiol 307: R1275-R1291, 2014. First published September 24, 2014 doi:10.1152/ajpregu.00185.2014.-Obesity and its related comorbidities can be detrimental for the affected individual and challenge public health systems worldwide. Currently, the only available treatment options leading to clinically significant and maintained body weight loss and reduction in obesity-related morbidity and mortality are based on surgical interventions. This review will focus on two main clinical effects of Roux-en-Y gastric bypass (RYGB), namely body weight loss and change in eating behavior. Animal experiments designed to understand the underlying physiological mechanisms of these post-gastric bypass effects will be discussed. Where appropriate, reference will also be made to vertical sleeve gastrectomy. While caloric malabsorption and mechanical restriction seem not to be major factors in this respect, alterations in gut hormone levels are invariably found after RYGB. However, their causal role in RYGB effects on eating and body weight has recently been challenged. Other potential factors contributing to the RYGB effects include increased bile acid concentrations and an altered composition of gut microbiota. RYGB is further associated with remarkable changes in preference for different dietary components, such as a decrease in the preference for high fat or sugar. It needs to be noted, however, that in many cases, the question about the necessity of these alterations for the success of bariatric surgery procedures remains unanswered.Roux-en-Y gastric bypass; vertical sleeve gastrectomy; gut hormones; restriction; malabsorption; energy expenditure THE OBESITY EPIDEMIC AND ITS related comorbidities constitute a major challenge for both personal health and public health systems worldwide. The enormous increase in knowledge about the physiological mechanisms that control eating and body weight contrasts with the lack of available pharmacological therapies leading to safe, efficient, and long-lasting body weight reductions and amelioration of obesity-related comorbidities. However, recent insights into underlying mechanisms of obesity and bariatric surgery have led to promising perspectives in respect to gut hormone-based strategies against obesity. Nevertheless, best results for maintained weight reduction and improvement of comorbidities are still achieved by surgical means (22,88,121,135,136). This review aims to summarize key findings in respect to underlying physiological mechanisms of the Roux-en-Y gastric bypass (RYGB) procedure, which is the most commonly performed bariatric operation worldwide and thus, by many is considered as the gold standard in bariatric surgery. Sporadic reference will also be made to vertical sleeve gastrectomy (VSG) when appropriate. Both operations reduce eating at least temporarily (19,140,143) and lead to changes in food preferences (20,27,72). The majority of data collected with...

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Section: Energy Expendituresupporting

confidence: 77%

supporting

confidence: 70%

Section: Energy Expenditurementioning

confidence: 97%

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The physiology underlying Roux-en-Y gastric bypass: a status report

Lutz

Bueter

2014

American Journal of Physiology-Regulatory, Integrative and Comp

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“…They include many changes that are known to impact REE and are also known to occur with RYGB and WL, including increases in diet-induced thermogenesis after RYGB 7 and other known physiologic changes such as post-prandial levels of gastrointestinal and pancreatic hormone levels 5, 14 , changes in gut microbiota 9 and others. RYGB promotes changes in postprandial levels of many gastrointestinal and pancreatic hormone levels including peptide YY (PYY) and glucagon-like-peptide 1 (GLP-1) that have been found to alter diet-induced energy and resting energy expenditure 14 .…”

Section: Discussionmentioning

confidence: 99%

“…ghrelin, glucagon-like-peptide 1, glucose-dependent insulinotropic polypeptide, peptide YY) and pancreatic (insulin, glucagon, pancreatic polypeptide) hormone levels 5 . These hormones affect gastric emptying, glucose regulatory mechanisms, central nervous system hunger and satiety mechanisms 6 in addition to changes in diet induced thermogenesis 7 , bile acid metabolism 8 and gut microbiota composition 9 . It has been recently suggested that persons undergoing RYGB may also have increases in weight-adjusted resting energy expenditure (Wt-REE) after substantial WL has occurred.…”

Section: Introductionmentioning

confidence: 99%

Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone

Rabl

Rao

Schwarz

et al. 2014

Surgery

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Background The mechanisms by which bariatric surgery achieves weight loss (WL) are under scrutiny. We assessed changes in resting energy expenditure (REE) after gastric bypass (RYGB) and gastric banding (AGB) to determine if changes in REE are associated with WL and type of surgery. Methods Three groups of morbidly obese patients were studied: RYGB (n=12), AGB (n=8), and a control group that underwent caloric restriction alone (Diet, n=10). Studies were performed at baseline and after 14 days in all groups, and 6 months after RYGB and AGB. REE (kcal/day) was measured by indirect calorimetry and adjusted for body weight (Wt-REE), and lean body mass by dual-energy X-ray absorptiometry (LBM-REE). Results At baseline, REE did not differ significantly among groups (RYGB=2,114±337, AGB=1,837±154, Diet=2,091±363 kcal/day, p=0.13). After 14 days, the groups had similar percent excess WL (%EWL). Neither Wt-REE nor LBM-REE changed significantly in any group. After six months %EWL was 49±10% after RYGB and 21±11% after AGB (p<0.01); RYGB patients had greater increase in the percent of weight that was LBM (RYGB=7.9±3.0 vs. AGB=1.6±1.5%, p<0.01).Wt-REE increased significantly only after RYGB (+2.58±1.51 kcal/kg/day, p<0.01). There was a significant correlation between changes in Wt-REE and %EWL (r=0.670, p=0.003). Conclusion The increase in Wt-REE may be a factor supporting WL after RYGB.

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Weight Recidivism After Roux‐en‐Y Gastric Bypass Surgery: An 11‐Year Experience in a Multiethnic Medical Center

Thomas

Anderson

Apovian

et al. 2018

Obesity

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Objective: Weight recidivism following Roux-en-Y gastric bypass (RYGB) is common and is associated with recurrence of comorbidities. Studies with long-term follow-up of recidivism quantified by weight regain (WR) are lacking. A retrospective review of all RYGB at our center from 2004 to 2015 was performed to examine the effects of race and type 2 diabetes on WR following RYGB. Methods: Multivariable linear mixed models were used for the effects of time and race on weight, WR relative to nadir weight (WR/nadir), and WR relative to maximal weight loss, and Cox regressions were used for low, moderate, and high WR/nadir. Results: A total of 1,395 participants were identified. The sample was limited to African American (AA), Caucasian American (CA), and Hispanic American (HA) participants. The effects of time (P < 0.0001), race (P < 0.0001), and race × time interaction (P = 0.0008) on weight trajectory were significant. AA had significantly more WR than CA (P < 0.01). AA and HA had a higher hazard ratio for having low, moderate, and rapid WR/nadir. Conclusions: Racial disparities after RYGB include WR and particularly affect AA. Understanding the etiologic factors that contribute to these disparities is important to optimize the long-term clinical outcomes of bariatric surgery.

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Diet-induced thermogenesis and respiratory quotient after Roux-en-Y gastric bypass

Cited by 34 publications

References 27 publications

The physiology underlying Roux-en-Y gastric bypass: a status report

The physiology underlying Roux-en-Y gastric bypass: a status report

Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone

Weight Recidivism After Roux‐en‐Y Gastric Bypass Surgery: An 11‐Year Experience in a Multiethnic Medical Center

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