Surgery for obesity

Bariatric surgery, or weight-loss surgery, are the various surgical procedures to treat obe¬sity by modification of the gastrointestinal tract to reduce nutrient intake and/or absorption. This review discusses how appetite and levels of gastrointestinal hormones are altered after bariatric surgery.

Surgical removal of.body fat such as liposuction or abdo¬minoplasty are not considered bariatric surgical proce¬dures.

Surgical pro¬cedures can be grouped in two main categories:

Restrictive procedures, e.g. gastric banding reducing the volume of the stomach and physically preventing excessive consumption of food

Or bypass proce¬dures, e.g. Roux-en- Y gastric bypass , a small stomach pouch is created with a stapler and bypasses the stomach remnant.

Gut hormones are an important element in appetite regulation as a result of the signals from the periphery to the brain. Such hormones include ghrelin, peptide YY, glucagon-like peptide-l and gastric inhibitory polypeptide, all of which are currently being investigated as potential obesity treat¬ments.

Bariatric surgery is currently the most effective therapy for substantial and sustained weight loss. Understanding how levels of gut hormones are modulated by such procedures has greatly contributed to the comprehension of the underlying mechanisms of appetite and obesity.
Bueter and le Roux 2009 Bariatric surgery as a model to study appetite control , Proceedings of the Nutrition Society vol 68 , 227-233

Martin Eastwood
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