Long-Term Modulation of Appetitive Hormones and Sweet Cravings After Adjustable Gastric Banding and Roux-en-Y Gastric Bypass

Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

“…Other mediators of fullness and satiety related to the mechanical changes after SG, such as increases in gastric pressure and vagal firing, could contribute to these findings. Interestingly, there was a trend toward decreased sweet cravings after RYGB, which recapitulates the findings of a prior study comparing LAGB with RYGB where LAGB patients had no change in sweet cravings and RYGB patients had significantly lower fasting and postprandial sweet cravings [26]. GLP-1 and PYY are potential mediators of this effect as they have been shown to enhance the ability to taste sweet flavors and heighten aversion to sweet taste [55,56].…”

“…Both procedures result in a dysregulation of ghrelin when compared with non-surgical weight loss or laparoscopic adjustable gastric banding (LAGB), which result in a rise in fasting ghrelin and maintenance of meal-related decreases [25,26]. In contrast, there was no significant change in ghrelin levels after RYGB, although it should be noted that by two years and later after RYGB, ghrelin levels do increase [26] and there was a large decrease after SG. In our study, pre-operative ghrelin levels were greater in the SG group compared with RYGB for unclear reasons.…”

“…Ghrelin is an appetite stimulating neuropeptide secreted by the gastric fundus and proximal small intestine to increase food intake, gut motility, and decrease insulin secretion [23,24]. Ghrelin levels increase during fasting, are suppressed following meal intake, and increase in response to diet-induced weight loss or adjustable gastric banding [25][26][27].…”

Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps—a Scoping Review

“…[8,20] or > 15% of nadir weight [8,9,21,22] Using nadir weight kg ≥ 10 kg from nadir [8,[21][22][23] Using maximum WL ≥ 10% [8,24], ≥ 20 [8,25] or ≥ 25 [8,26] of maximum WL Using pre-surgery weight ≥ 10% WR of pre-surgery weight [8,27] Using any WR after remission Any WR after T2DM remission [ Hormonal and Metabolic Weight loss after BS is due to the anatomical exclusion of the foregut. This leads to a hormonal upregulation of pancreatic peptide YY, glucagon-like peptide-1 (GLP-1), and gastric inhibitory polypeptide hormones which promote satiety and minimize hunger, as well as downregulation of ghrelin with subsequent decrease in food intake [40,41]. With time, alterations in the levels of ghrelin, leptin, and incretins diminish, resulting in WR [42][43][44].…”

“…Summary of causes, predictors, and prevention and management strategies of WR and IWL after BSCharacteristic SummaryCauses Hormonal/metabolic Increase in ghrelin, decrease in peptide YY and GLP-1, post-bariatric hypoglycemia, role of leptin is unclear[24,[40][41][42][43][44][45][46][47][48][49] …”