Resting Energy Expenditure in Long-Term Postobese Subjects after Weight Normalization by Dieting or Biliopancreatic Diversion

Adami, Gian Franco; Compostano, A; Bessarione, D.; Gandolfo, Patrizia; Marinari, Giuseppe M.; Lamedica, G; Scopinaro, Nicola

doi:10.1381/096089293765559106

Cited by 15 publications

(4 citation statements)

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“…In fact, the massive weight loss of RYGB occurs in the setting of metabolic adaptation (decreased energy demands greater than expected for the degree of weight loss), suggesting the contribution of hormonal or neuronal factors (or both) in the anorectic effect 110 . The effects of RYGB on energy expenditure appear to be contrary to those observed in BPD, which Scopinaro and colleagues have reported 111 . Overall, when examining the metabolic and body weight changes observed both acutely and chronically by RYGB and comparing those with BPD, researchers are tempted to speculate that the BPD operation represents an extreme physiologic response.…”

Section: More Than Gastric Restriction: Operations With Hormonal Effecontrasting

confidence: 62%

Recent advances in metabolic and bariatric surgery

et al. 2016

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Obesity and its associated medical conditions continue to increase and add significant burden to patients, as well as health-care systems, worldwide. Bariatric surgery is the most effective treatment for severe obesity and its comorbidities, and resolution of diabetes is weight loss-independent in the case of some operations. Although these weight-independent effects are frequently described clinically, the mechanisms behind them are not well understood and remain an intense area of focus in the growing field of metabolic and bariatric surgery. Perceptions of the mechanisms responsible for the beneficial metabolic effects of metabolic/bariatric operations have shifted from being mostly restrictive and malabsorption over the last 10 to 15 years to being more neuro-hormonal in origin. In this review, we describe recent basic and clinical findings of the major clinical procedures (adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion) as well as other experimental procedures (ileal interposition and bile diversion) that recapitulate many of the metabolic effects of these complex operations in a simpler fashion. As the role of bile acids and the gut microbiome on metabolism is becoming increasingly well described, their potential roles in these improvements following metabolic surgery are becoming better appreciated. Bile acid and gut microbiome changes, in light of recent developments, are discussed in the context of these surgical procedures, as well as their implications for future study.

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Section: More Than Gastric Restriction: Operations With Hormonal Effecontrasting

confidence: 62%

Recent advances in metabolic and bariatric surgery

et al. 2016

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“…After weight loss, significant reductions in energy expenditure favoring the regain of lost weight have been shown [38][39][40]. However, after biliopancreatic diversion (BPD), energy expenditure studied at different time-points has been observed to be significantly higher than that of nonobese controls [41]. Moreover, in rat models, it has been shown that the BPD induces a negative energy balance [42,43].…”

Section: Discussionmentioning

confidence: 99%

RIP140 Gene and Protein Expression Levels are Downregulated in Visceral Adipose Tissue in Human Morbid Obesity

et al. 2009

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“…Furthermore, all of the many obese women with a preoperative TEE lower than 1750 kcal/day lost weight after BPD. Therefore an increase of energy expenditure after BPD had to be hypothesized, already suggested by three previous studies [13][14][15] demonstrating that after BPD there was an energy expenditure greater than what was theoretically expected after the observed weight reduction.…”

Section: Weight Maintenancementioning

confidence: 93%

Biliopancreatic Diversion

et al. 1998

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Biliopancreatic diversion (BPD) has made reacceptable the malabsorptive approach to the surgical treatment of obesity. The procedure, in a series of 2241 patients operated on during a 21-year period, caused a mean permanent reduction of about 75% of the initial excess weight. The indefinite weight maintenance appears to be due to the existence of a threshold absorption capacity for fat and starch, and thus energy, and the weight loss is partly due to increased resting energy expenditure. Beneficial effects other than those consequent to weight loss or reduced nutrient absorption included permanent normalization of serum glucose and cholesterol without any medication and on totally free diet in 100% of cases, both phenomena being due to a specific action of the operation. Operative mortality was less than 0.5%. Specific late complications included anemia, less than 5% with adequate iron or folate supplementation (or both); stomal ulcer, reduced to 3.2% by oral H 2blocker prophylaxis; bone demineralization, increasing up to the fourth year and tending to decrease thereafter, with need of calcium and vitamin D supplementation; neurologic complications, totally avoidable by prompt vitamin B administration to patients at risk; protein malnutrition, which was reduced to a minimum of 3% with 1.3% recurrence, in exchange with a smaller weight loss, by adapting the volume of the gastric remnant and the length of the alimentary limb to the patient's individual characteristics. It is concluded that the correct use of BPD, based on the knowledge of its mechanisms of action, can make the procedure an effective, safe one in all hands.

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Resting Energy Expenditure in Long-Term Postobese Subjects after Weight Normalization by Dieting or Biliopancreatic Diversion

Cited by 15 publications

References 0 publications

Recent advances in metabolic and bariatric surgery

Recent advances in metabolic and bariatric surgery

RIP140 Gene and Protein Expression Levels are Downregulated in Visceral Adipose Tissue in Human Morbid Obesity

Biliopancreatic Diversion

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