scholarly journals Mechanisms of weight loss after obesity surgery

2021 ◽  
Author(s):  
Elina Akalestou ◽  
Alexander D Miras ◽  
Guy A Rutter ◽  
Carel W le Roux
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastrointestinal Tract ◽  
Energy Expenditure ◽  
Obesity Surgery ◽  
Control Release ◽  
Gut Peptides ◽  
Appetite Control ◽  
Metabolic Outcomes ◽  
Weight Loss Interventions

Abstract Obesity surgery remains the most effective treatment for obesity and its complications. Weight loss was initially attributed to decreased energy absorption from the gut but have since been linked to reduced appetitive behaviour and potentially increased energy expenditure. Implicated mechanisms associating rearrangement of the gastrointestinal tract with these metabolic outcomes include central appetite control, release of gut peptides, change in microbiota and bile acids. However, the exact combination and timing of signals remain largely unknown. In this review, we survey recent research investigating these mechanisms, and seek to provide insights on unanswered questions over how weight loss is achieved following bariatric surgery which may eventually lead to safer, nonsurgical weight-loss interventions or combinations of medications with surgery.

Accuracy of total energy expenditure predictive equations after a massive weight loss induced by bariatric surgery

2018 ◽  
Vol 26 ◽  
pp. 57-65 ◽  
Author(s):  
Michele Novaes Ravelli ◽  
Dale A. Schoeller ◽  
Alex Harley Crisp ◽  
Natalie M. Racine ◽  
Karina Pfrimer ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Energy Expenditure ◽  
Total Energy ◽  
Massive Weight Loss ◽  
Total Energy Expenditure ◽  
Predictive Equations

Hormones and the gastrointestinal tract

2020 ◽  
pp. 2862-2870
Author(s):  
Rebecca Scott ◽  
T.M. Tan ◽  
S.R. Bloom
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Hormones ◽  
Gut Hormones ◽  
The Body ◽  
Hormonal Changes ◽  
Gut Peptides ◽  
Appetite Control ◽  
Drug Induced ◽  
Beneficial Effects ◽  
Fold Family

The gastrointestinal tract is the largest endocrine organ in the body, with its component cells dispersed along its length rather than being clustered in glands. More than 20 gut peptides integrate gastrointestinal function by regulating the actions of the epithelium, muscles, and nerves; they also affect the growth and development of the gut and have a major role in appetite control. They mostly work in an autocrine or paracrine manner. Gastrointestinal hormones include the gastrin–cholecystokinin family, the secretin superfamily, preproglucagon derivatives, the motilin–ghrelin family, the pancreatic polypeptide-fold family, and various other gut peptides. Gastrointestinal and other diseases may cause abnormalities of these gut peptides, for example: (1) achlorhydria (from atrophic gastritis or drug-induced) causes elevation of circulating gastrin; (2) malabsorptive conditions are associated with a decrease in the amount of peptides produced in the affected region, and a compensatory elevation of other peptides; and (3) obesity is associated with orexigenic (appetite-stimulating) and less satiating hormonal changes, and the beneficial effects of bariatric surgery are partly explained through alterations in gut hormones.

Diet Advancement after Weight Loss Surgery

2018 ◽  
Author(s):  
Laura Andromalos
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastrointestinal Tract ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Postoperative Period ◽  
Reflux Disease ◽  
Weight Loss Surgery ◽  
Early Postoperative Period ◽  
Defecatory Dysfunction

Diet advancement after bariatric surgery has not been standardized across various bariatric programs. It is generally agreed that patients should advance through a textured progression while the gastrointestinal tract heals; however, the content of each diet stage is open for interpretation. The postoperative diet is intended to promote healing and weight loss while minimizing diet-related complications. This review presents the literature regarding the progression of patients through a postoperative bariatric surgery diet, macro- and micronutrient needs in the early postoperative period, and management of common diet-related complications, including nausea, dumping syndrome, gastroesophageal reflux disease, and defecatory dysfunction. This review contains 5 tables and 45 references Key words: Bariatric surgery, bariatric surgery diet, postoperative diet, macro-nutrient needs, micro-nutrient needs, diet-related complications

scholarly journals Transforming with partner patients a program of preparation for bariatric surgery

2019 ◽  
Vol 11 (2) ◽  
pp. 20402 ◽  
Author(s):  
Florence Somers ◽  
Jorge Correia ◽  
Valérie Blyweert ◽  
Minoa Jung ◽  
Zoltan Pataky ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Focus Groups ◽  
Obesity Surgery ◽  
Evaluation Process ◽  
Interdisciplinary Team ◽  
Preparation Program ◽  
Support Weight ◽  
Creation Process ◽  
The Creation

Introduction: The current collective preparation program for obesity surgery is performed by an interdisciplinary team over four non-consecutive days. In order to optimize the delays of the program and to improve the educational offer a temporal condensation of this service in the proximity of the intervention was decided. The objective of this study is to describe the creation process of the new obesity surgery preparation program based on the needs of partner patients. Materials and methods: We conducted semi-structured focus groups with 50 patients over 3 successive stages of the surgical journey: at the beginning and end of the collective preparation and then 2 to 14 months after the surgery. The analysis crosses by theme the needs identified. Results and discussion: Our study allowed to authenticate a central need of sharing with witnesses, a need for information (medical, dietary, behavioral), and a need for longer-term projection (transformations, investment axes to support weight loss). Conclusion: The preparatory needs identified by the partner patients served as a guide for the transformation of the existing program. This experiment paves the way for a partnership with patients established and recognized by the institution of care in the evaluation process of this program.

scholarly journals Obesity, preoperative weight loss, and telemedicine before total joint arthroplasty: a review

Arthroplasty ◽  
2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael W. Seward ◽  
Antonia F. Chen
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Mobile Health ◽  
Total Joint Arthroplasty ◽  
Severe Obesity ◽  
Deep Infection ◽  
Joint Arthroplasty ◽  
Preoperative Weight Loss ◽  
Preoperative Weight ◽  
Weight Loss Interventions

AbstractThe preoperative period prior to elective total joint arthroplasty (TJA) is a critical time for lifestyle interventions since a scheduled surgery may help motivate patients to lose weight. Weight loss may reduce complications associated with obesity following TJA and enable patients with severe obesity (body mass index [BMI] > 40 kg/m2) to become eligible for TJA, as many institutions use a 40 kg/m2 cut-off for offering surgery. A comprehensive review was conducted to (1) provide background on complications associated with obesity following TJA, (2) synthesize prior research on the success rate of patients losing weight after being denied TJA for severe obesity, (3) discuss bariatric surgery before TJA, and (4) propose mobile health telemedicine weight loss interventions as potential weight loss methods for patients preoperatively.It is well established that obesity increases complications associated with TJA. In total knee arthroplasty (TKA), obesity increases operative time, length of stay, and hospitalization costs as well as the risk of deep infection, revision, and component malpositioning. Obesity may have an even larger impact on complications associated with total hip arthroplasty (THA), including wound complications and deep infection. Obesity also increases the risk of hip dislocation, aseptic loosening, and venous thromboembolism after THA.Synthesis of the only two studies (n = 417), to our knowledge, that followed patients denied TJA for severe obesity demonstrated that only 7% successfully reduced their BMI below 40 kg/m2 via lifestyle modifications and ultimately underwent TJA. Unfortunately, bariatric surgery may only increase certain post-TKA complications including death, pneumonia, and implant failure, and there is limited research on preoperative weight loss via lifestyle modification. A review of short-term mobile health weight loss interventions that combined personalized counseling with self-monitoring via a smartphone app found about 5 kg of weight loss over 3-6 months. Patients with severe obesity have more weight to lose and may have additional motivation to do so before TJA, so weight loss results may differ by patient population. Research is needed to determine whether preoperative mobile health interventions can help patients become eligible for TJA and produce clinically significant weight loss sufficient to improve postoperative outcomes.

scholarly journals Changes in C-reactive protein, neopterin and lactoferrin differ after conservative and surgical weight loss in individuals with morbid obesity

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Martin Aasbrenn ◽  
Per G. Farup ◽  
Vibeke Videm
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Body Mass ◽  
Weight Loss Intervention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Surgical Weight Loss ◽  
Weight Loss Interventions

AbstractC-reactive protein, neopterin and lactoferrin are biomarkers of atherosclerotic disease. We aimed to assess changes in these biomarkers after conservative and surgical weight loss interventions in individuals with morbid obesity, to evaluate associations between biomarker changes and changes in body mass index and HbA1c, and to study associations between changes in the biomarkers. C-reactive protein, neopterin and lactoferrin were measured before and after conservative weight loss intervention and bariatric surgery. Data were analysed with mixed models. 137 individuals (mean age 43 years) were included. Body mass index decreased from 42.1 kg/m2 to 38.9 kg/m2 after the conservative intervention, and further to 30.5 kg/m2 after bariatric surgery. All biomarkers decreased after the conservative weight loss intervention. C-reactive protein and lactoferrin continued to decrease following bariatric surgery whereas neopterin remained stable. After adjustments for change in body mass index and HbA1c, all biomarkers decreased significantly after the conservative weight loss intervention, whereas none changed after bariatric surgery. There were no consistent correlations between changes in C-reactive protein, neopterin and lactoferrin. In conclusion, biomarkers of atherosclerosis decreased after weight loss interventions but had different trajectories. Neopterin, a marker related to atherosclerotic plaque stability, decreased after conservative weight loss but not following bariatric surgery.

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