Regulation of body weight: Lessons learned from bariatric surgery

Albaugh, Vance L.; He, Yanlin; Münzberg, Heike; Morrison, Christopher; Yu, Sangho; Berthoud, Hans‐Rudolf

doi:10.1016/j.molmet.2022.101517

Cited by 38 publications

(14 citation statements)

References 293 publications

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“…Metabolic surgery no longer only includes mechanically restrictive and/or malabsorptive procedures, but also metabolic procedures that involve complex physiological changes [ 10 ]. These involve gut adaptation and influence the signaling pathways in several organs, such as the brain and liver, that regulate hunger, satiation and satiety, body weight, glucose metabolism, and immune functions [ 7 , 42 ]. Improvements have been noted after metabolic surgery, in which incretins, bile acids, and the microbiomes play their role in a complex interplay to improve metabolic health [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are risks and complications associated with metabolic surgeries, which range from immediate, surgical-related complications to mortality [ 6 ]. Metabolic surgery’s overall physiological and behavioral effects do not involve a single mechanism, but multiple signaling pathways [ 7 ]. Understanding the mechanism of the effect of metabolic surgeries on diabetes could lead to precision medicine.…”

Section: Introductionmentioning

confidence: 99%

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Molecular, Metabolic, and Nutritional Changes after Metabolic Surgery in Obese Diabetic Patients (MoMen): A Protocol for a Multicenter Prospective Cohort Study

et al. 2023

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Metabolic surgery is an essential option in the treatment of obese patients with type 2 diabetes (T2D). Despite its known advantages, this surgery still needs to be introduced in Malaysia. In this prospective study, the pathophysiological mechanisms at the molecular level will be studied and the metabolomics pathways of diabetes remission will be explored. The present study aims to evaluate the changes in the anthropometric measurements, body composition, phase angle, diet intake, biochemistry parameters, adipokines, microRNA, and metabolomics, both pre- and post-surgery, among obese diabetic patients in Malaysia. This is a multicenter prospective cohort study that will involve obese patients (n = 102) with a body mass index (BMI) of ≥25 kg/m2 (Asian BMI categories: WHO/IASO/IOTF, 2000) who will undergo metabolic surgery. They will be categorized into three groups: non-diabetes, prediabetes, and diabetes. Their body composition will be measured using a bioimpedance analyzer (BIA). The phase angle (PhA) data will be analyzed. Venous blood will be collected from each patient for glycated hemoglobin (HbA1c), lipids, liver, renal profile, hormones, adipokines, and molecular and metabolomics analyses. The serum microRNA will be measured. A gene expression study of the adipose tissue of different groups will be conducted to compare the groups. The relationship between the 1HNMR-metabolic fingerprint and the patients’ lifestyles and dietary practices will be determined. The factors responsible for the excellent remission of T2D will be explored in this study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Molecular, Metabolic, and Nutritional Changes after Metabolic Surgery in Obese Diabetic Patients (MoMen): A Protocol for a Multicenter Prospective Cohort Study

et al. 2023

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“…Surgical therapy for weight loss has been discussed to convey more benefits to the patient than solely on the metabolic level, including neuroplasticity (45,46) . A considerable number of pre-to-post-surgery MRI analyses in relatively small sample sizes indeed indicated a certain recovery of structural and functional brain measures as well as cognitive performance after surgery [reviewed in (47) ], with the common limitation of lacking a longitudinal obese control group (see also Section 'Challenges of MRI in obesity and intervention studies'): for an in-depth review on bariatric surgery and weight loss mechanisms, see (48) . When compared to waiting list patients, a recent study found that reduction of stomach size (i.e.…”

Section: Obesity Surgerymentioning

confidence: 99%

Impact of obesity and diet on brain structure and function: a gut–brain–body crosstalk

Medawar

Witte

2022

Proc. Nutr. Soc.

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Most societies witness an ever increasing prevalence of both obesity and dementia, a scenario related to often underestimated individual and public health burden. Overnutrition and weight gain have been linked with abnormal functionality of homoeostasis brain networks and changes in higher cognitive functions such as reward evaluation, executive functions and learning and memory. In parallel, evidence has accumulated that modifiable factors such as obesity and diet impact the gut–brain axis and modulate brain health and cognition through various pathways. Using neuroimaging data from epidemiological studies and randomised clinical trials, we aim to shed light on the underlying mechanisms and to determine both determinants and consequences of obesity and diet at the level of human brain structure and function. We analysed multimodal 3T MRI of about 2600 randomly selected adults (47 % female, 18–80 years of age, BMI 18–47 kg/m2) of the LIFE-Adult study, a deeply phenotyped population-based cohort. In addition, brain MRI data of controlled intervention studies on weight loss and healthy diets acquired in lean, overweight and obese participants may help to understand the role of the gut–brain axis in food craving and cognitive ageing. We find that higher BMI and visceral fat accumulation correlate with accelerated brain age, microstructure of the hypothalamus, lower thickness and connectivity in default mode- and reward-related areas, as well as with subtle grey matter atrophy and white matter lesion load in non-demented individuals. Mediation analyses indicated that higher visceral fat affects brain tissue through systemic low-grade inflammation, and that obesity-related regional changes translate into cognitive disadvantages. Considering longitudinal studies, some, but not all data indicate beneficial effects of weight loss and healthy diets such as plant-based nutrients and dietary patterns on brain ageing and cognition. Confounding effects of concurrent changes in other lifestyle factors or false positives might help to explain these findings. Therefore a more holistic intervention approach, along with open science tools such as data and code sharing, in-depth pre-registration and pooling of data could help to overcome these limitations. In addition, as higher BMI relates to increased head micro-movements during MRI, and as head motion in turn systematically induces image artefacts, future studies need to rigorously control for head motion during MRI to enable valid neuroimaging results. In sum, our results support the view that overweight and obesity are intertwined with markers of brain health in the general population, and that weight loss and plant-based diets may help to promote brain plasticity. Meta-analyses and longitudinal cohort studies are underway to further differentiate causation from correlation in obesity- and nutrition-brain research.

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“…Among the available treatment options, bariatric surgery successfully reduces both premature mortality and comorbidities at a population level [ 2 ]. Research has continued to demonstrate that bariatric surgery dominates in effectiveness as a top treatment for obesity [ 3 ]. Bariatric surgery typically encompasses a few main procedures, including laparoscopic sleeve gastrectomy, laparoscopic gastric bypass, and laparoscopic adjustable banding.…”

Section: Introductionmentioning

confidence: 99%

Perforated Duodenal Ulcer Post-Roux-en-Y Gastric Bypass: A Case Report

Hughes¹,

Morris²,

Que³

et al. 2023

Cureus

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Obesity is a growing health concern worldwide, with bariatric surgeries such as gastric bypass providing an effective treatment choice. However, a rare complication of gastric bypass is a duodenal ulcer. Currently, there is no exact incidence of this complication, and only a few case reports have been published in the literature. Presented is a case of a 32-year-old patient, eight years status post gastric bypass, who was evaluated for surgical repair of a large anterior perforated duodenal ulcer. This case report explores the relationship between patient history and gastric bypass surgery in the case of duodenal ulcer formation and perforation, as well as the diagnostic difficulty and modalities for duodenal ulcers in post-gastric bypass patients.

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Regulation of body weight: Lessons learned from bariatric surgery

Cited by 38 publications

References 293 publications

Molecular, Metabolic, and Nutritional Changes after Metabolic Surgery in Obese Diabetic Patients (MoMen): A Protocol for a Multicenter Prospective Cohort Study

Molecular, Metabolic, and Nutritional Changes after Metabolic Surgery in Obese Diabetic Patients (MoMen): A Protocol for a Multicenter Prospective Cohort Study

Impact of obesity and diet on brain structure and function: a gut–brain–body crosstalk

Perforated Duodenal Ulcer Post-Roux-en-Y Gastric Bypass: A Case Report

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