Body Composition and Energy Expenditure in Obese Patients prior to and following Biliopancreatic Diversion for Obesity

Adami, Gian Franco; Campostano, Adelia; Gandolfo, Patrizia; Marinari, Giuseppe M.; Bessarione, D.; Scopinaro, N.

doi:10.1159/000129469

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…This demonstrates that the lipid content of the adipocytes was greatly decreased following surgery. Adami et al 22 found that 80% of the first postoperation weight loss in human subjects with BPD was due to an FM loss. The reducing effect of the BPD on FM deposition was more noticeable than the effect of the surgery on the FFM, which was nonetheless also reduced.…”

Section: Discussionmentioning

confidence: 99%

Effects of the biliopancreatic diversion on energy balance in the rat

Nadreau

Samson

et al. 2005

Int J Obes

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Objective: This study was carried out to determine the effects of the biliopancreatic diversion (BPD), a bariatric surgery applied to the treatment of morbidly obese humans, on energy balance in rats. Methods: BPD was performed on a group of male Wistar rats. Body weight and food intake were measured daily throughout the study. Feces were also collected to assess energy losses and the determination of digestible energy. Energy expenditure and body composition were also determined for the 50-day length of the protocol. On the day of killing, the brain, the entire intestinal tract and white and brown adipose tissues were collected and weighed. Expression of neuropeptide Y (NPY) and agouti-related protein (AgRP) in the ARC nucleus were assessed by in situ hybridization. Results: Marked changes in the regulation of energy balance were observed in the BPD-operated rats. A decrease in digestible energy and food intake coupled with an increase in the fecal energy density and protein fecal energy led to an important weight loss in the BPD-operated rats. This weight loss was observed in the loss of fat mass (specifically the white epididymal, inguinal, retroperitoneal and brown adipose tissues). The rats modified their food intake pattern to be able to potentially eat more during the entire day. An increase in the surfaces of all intestinal structures (muscular and mucosal layers) was observed in the BPDoperated rats. The NPY and AgRP expression in the brain were both shown to be greater in the BPD-operated rats than in the control animals. At the beginning of the study, the surgery led to an energy expenditure decrease, which, however, did not persist throughout the study despite the fact that BPD-operated rats exhibited persistent lower fat free masses. Conclusion: BPD led to a noticeable reduction in weight and fat gains in rats, which was in large part owing to a decrease in digestible energy intake led to by the gastrectomy, the intestinal malabsorption inherent to the surgery and to potentially a thermogenesis stimulation that occurred in the second end of the study. The reduction in energy gain occurs despite adaptations to thwart the intestinal malabsorption and the hunger signals from the central nervous system.

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Section: Discussionmentioning

confidence: 99%

Effects of the biliopancreatic diversion on energy balance in the rat

Nadreau

Samson

et al. 2005

Int J Obes

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“…Weight loss in rodent models of RYGB is associated with preservation of lean body mass and increased EE [ 146 ]. Humans have decreased basal metabolic rate, but increased meal-induced thermogenesis after RYGB [ 32 , 122 , 147 – 153 ]. Evidence is now also emerging to suggest that the metabolic rate of the small bowel is increased after RYGB with more carbohydrate consumption which may explain the changes observed in respiratory quotient after these operations [ 154 ].…”

Section: Energy Expenditurementioning

confidence: 99%

Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review

2015

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Various bariatric surgical procedures are effective at improving health in patients with obesity associated co-morbidities, but the aim of this review is to specifically describe the mechanisms through which Roux-en-Y gastric bypass (RYGB) surgery enables weight loss for obese patients using observations from both human and animal studies. Perhaps most but not all clinicians would agree that the beneficial effects outweigh the harm of RYGB; however, the mechanisms for both the beneficial and deleterious (for example postprandial hypoglycaemia, vitamin deficiency and bone loss) effects are ill understood. The exaggerated release of the satiety gut hormones, such as GLP-1 and PYY, with their central and peripheral effects on food intake has given new insight into the physiological changes that happen after surgery. The initial enthusiasm after the discovery of the role of the gut hormones following RYGB may need to be tempered as the magnitude of the effects of these hormonal responses on weight loss may have been overestimated. The physiological changes after RYGB are unlikely to be due to a single hormone, or single mechanism, but most likely involve complex gut-brain signalling. Understanding the mechanisms involved with the beneficial and deleterious effects of RYGB will speed up the development of effective, cheaper and safer surgical and non-surgical treatments for obesity.

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“…This results in a life-long threshold energy absorption that explains the life-long weight maintenance after the procedure [4]. An additional mechanism that ulteriorly lowers the weight of stabilization is the increased resting energy expenditure due to the adaptive hypertrophy of the entire highly consuming small bowel [5].…”

Section: The Operation and Its Mechanisms Of Actionmentioning

confidence: 99%