Gastric Emptying Rate after Gastric Bypass and Gastroplasty

Näslund, Ingmar; Beckman, Karl-Wilhelm

doi:10.3109/00365528708991879

Cited by 55 publications

(56 citation statements)

References 22 publications

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“…Accelerated gastric emptying and intestinal transit have been demonstrated following RYGB, with GLP-1 level magnitude correlating with gastric emptying time (130). Other studies report delayed gastric emptying to solids (77,137) and faster emptying to liquids (77) following RYGB, but the interpretation of these findings is complicated because GLP-1 itself slows gut transit. Notably, however, changes in PYY level do not correlate with gastric emptying time (130), casting doubt on this mechanism.…”

Section: Mechanisms Of Weight Loss After Rygbmentioning

confidence: 91%

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Scott

Batterham

2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Obesity increases the likelihood of diseases like type 2 diabetes (T2D), heart disease, and cancer, and is one of the most serious public health problems of this century. In contrast to ineffectual prevention strategies, lifestyle modifications, and pharmacological therapies, bariatric surgery is a very effective treatment for morbid obesity and also markedly improves associated comorbidities like T2D. However, weight loss and resolution of T2D after bariatric surgery is heterogeneous and specific to type of bariatric procedure performed. Conventional mechanisms like intestinal malabsorption and gastric restriction do not fully explain this, and potent changes in appetite and the enteroinsular axis, as a result of anatomical reorganization and altered hormonal, neuronal, and nutrient signaling, are the portended cause. Uniquely these signaling changes appear to override vigorous homeostatic defenses of stable body weight and compelling self-gratifying motivations to eat and to reverse defects in beta-cell function and insulin sensitivity. Here we review mechanisms of weight loss and T2D resolution after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy bariatric surgery, two markedly different procedures with robust clinical outcomes.

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Section: Mechanisms Of Weight Loss After Rygbmentioning

confidence: 91%

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Scott

Batterham

2011

American Journal of Physiology-Regulatory, Integrative and Comp

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“…A total of 15 RCTs compared different surgical procedures: eight RCTs comparing GB with GP, [45][46][47][48][49][50][51][52][53][54][55][56][57]61 two RCTs comparing GB with JB, [40][41][42]44 one RCT comparing VBG with horizontal GP, 38 one RCT comparing VBG with AGB, 35 two RCTs comparing open versus laparoscopic GB, 36,37 and one RCT that compared open versus laparoscopic ASGB. 43 Methodological quality varied between RCTs ( Table 7 ).…”

Section: Comparison Of Different Surgical Procedures Quantity and Quamentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation

Clegg

Colquitt

Sidhu

et al. 2002

Health Technol Assess

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“…In addition, it is possible that intestinal peristalsis is compromised by the jejunal transection. Studies in RYGB patients suggest that, while emptying of liquids is accelerated, emptying of solid food is slower (13,29,32), and 1 mo after surgery, gastric emptying rate measured 4 h after the start of 2-h access to regular chow was ϳ25% slower after RYGB compared with control obese Sprague-Dawley rats (46). The slower emptying of solids could bring mechanosensory mechanisms in the gastric pouch into play to explain RYGB-induced reduction of solid food meal size.…”

Section: Meal Patternsmentioning

confidence: 99%

Meal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery

Zheng

Shin

Lenard

et al. 2009

American Journal of Physiology-Regulatory, Integrative and Comp

155

144

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September 2, 2009; doi:10.1152/ajpregu.00343.2009.-Gastric bypass surgery efficiently and lastingly reduces excess body weight and reverses type 2 diabetes in obese patients. Although increased energy expenditure may also play a role, decreased energy intake is thought to be the main reason for weight loss, but the mechanisms involved are poorly understood. Therefore, the aim of this study was to characterize the changes in ingestive behavior in a rat model of Roux-en-Y gastric bypass surgery (RYGB). Obese (24% body fat compared with 18% in chow-fed controls), male Sprague-Dawley rats maintained for 15 wk before and 4 mo after RYGB or sham-surgery on a two-choice low-fat/high-fat diet, were subjected to a series of tests assessing energy intake, meal patterning, and food choice. Although sham-operated rats gained an additional 100 g body wt during the postoperative period, RYGB rats lost ϳ100 g. Intake of a nutritionally complete and palatable liquid diet (Ensure) was significantly reduced by ϳ50% during the first 2 wk after RYGB compared with sham surgery. Decreased intake was the result of greatly reduced meal size with only partial compensation by meal frequency, and a corresponding increase in the satiety ratio. Similar results were obtained with solid food (regular or high-fat chow) 6 wk after surgery. In 12-to 24-h two-choice liquid or solid diet paradigms with nutritionally complete low-and high-fat diets, RYGB rats preferred the low-fat choice (solid) or showed decreased acceptance for the high-fat choice (liquid), whereas sham-operated rats preferred the high-fat choices. A separate group of rats offered chow only before surgery completely avoided the solid high-fat diet in a choice paradigm. The results confirm anecdotal reports of "nibbling" behavior and fat avoidance in RYGB patients and provide a basis for more mechanistic studies in this rat model. obesity; diabetes; bariatric surgery; high-fat diet; food preference; meal patterns; satiety ratio THE DISAPPOINTING EFFECTIVENESS and serious side effects of drugs have made surgical approaches very attractive alternatives for treatment or even prevention of obesity, type 2 diabetes, and other sequelae of the metabolic syndrome. Major progress in surgical methodology and experience with an increasing number of operations each year has resulted in a much-improved rate of serious complications and mortality during the last decade. Large prospective studies with up to 15 years follow-up have shown that an obese patient with a body mass index (BMI) of Ն35 has a longer life expectancy with gastric bypass surgery than without, and a Ͼ80% chance of resolving preexisting diabetes, cardiovascular disease, and sleep apneas (1,5,25,33,42,43).Given these impressive effects and the expected continued rise in the number of bariatric surgeries, it is vexing not to understand the mechanisms involved. Identification of these mechanisms should eventually lead to the development of pharmacological or behavioral tools without the need for surgery, or less invasive surgery...

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Gastric Emptying Rate after Gastric Bypass and Gastroplasty

Cited by 55 publications

References 22 publications

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation

Meal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery

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