All bariatric surgeries are not created equal: insights from mechanistic comparisons

Margaret A Stefater, Hilary E Wilson-Pérez, Adam P Chambers, Darleen A Sandoval, Randy J Seeley, Margaret A Stefater, Hilary E Wilson-Pérez, Adam P Chambers, Darleen A Sandoval, Randy J Seeley

Abstract

Despite considerable scientific progress on the biological systems that regulate energy balance, we have made precious little headway in providing new treatments to curb the obesity epidemic. Diet and exercise are the most popular treatment options for obesity, but rarely are they sufficient to produce long-term weight loss. Bariatric surgery, on the other hand, results in dramatic, sustained weight loss and for this reason has gained increasing popularity as a treatment modality for obesity. At least some surgical approaches also reduce obesity-related comorbidities including type 2 diabetes and hyperlipidemia. This success puts a premium on understanding how these surgeries exert their effects. This review focuses on the growing human and animal model literature addressing the underlying mechanisms. We compare three common procedures: Roux-en-Y Gastric Bypass (RYGB), vertical sleeve gastrectomy (VSG), and adjustable gastric banding (AGB). Although many would group together VSG and AGB as restrictive procedures of the stomach, VSG is more like RYGB than AGB in its effects on a host of endpoints including intake, food choice, glucose regulation, lipids and gut hormone secretion. Our strong belief is that to advance our understanding of these procedures, it is necessary to group bariatric procedures not on the basis of surgical similarity but rather on how they affect key physiological variables. This will allow for greater mechanistic insight into how bariatric surgery works, making it possible to help patients better choose the best possible procedure and to develop new therapeutic strategies that can help a larger portion of the obese population.

Figures

Figure 1.
Figure 1.
Refeeding after an extended period of caloric restriction is associated with identical rate and magnitude of body weight regain in sham-operated rats fed either high-fat diet HFD (SHAM) or chow, pair-fed rats, and VSG-operated rats. No significant differences between groups. To accomplish this, all groups (including the VSG-operated rats) eat more calories after the restriction than in the baseline period before the restriction. [Data from Stefater MA et al.: Sleeve gastrectomy induces loss of weight and fat mass in obese rats, but does not affect leptin sensitivity. Gastroenterology 138:2426, 2010 (62), with permission. © Elsevier.]
Figure 2.
Figure 2.
RYGB and VSG are associated with comparable postprandial GLP-1 secretion. *, P < 0.05 vs. pair-fed; #, P < 0.05 vs. VSG; $, P < 0.05 vs. RYGB. [Data from Chambers AP et al.: Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology 141:950, 2011 (48), with permission. © Elsevier.]
Figure 3.
Figure 3.
Comparison of RYGB, AGB, and VSG.

References

    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. 2010. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303:235–241
    1. Chouillard EK, Karaa A, Elkhoury M, Greco VJ. 2011. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for morbid obesity: case-control study. Surg Obes Relat Dis 7:500–505
    1. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. 2009. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood) 28:w822–w831
    1. Anderson JW, Konz EC, Frederich RC, Wood CL. 2001. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 74:579–584
    1. Weiss EC, Galuska DA, Kettel Khan L, Gillespie C, Serdula MK. 2007. Weight regain in U.S. adults who experienced substantial weight loss, 1999–2002. Am J Prev Med 33:34–40
    1. Kraschnewski JL, Boan J, Esposito J, Sherwood NE, Lehman EB, Kephart DK, Sciamanna CN. 2010. Long-term weight loss maintenance in the United States. Int J Obes (Lond) 34:1644–1654
    1. Woods SC, Schwartz MW, Baskin DG, Seeley RJ. 2000. Food intake and the regulation of body weight. Annu Rev Psychol 51:255–277
    1. Bray GA. 2008. Lifestyle and pharmacological approaches to weight loss: efficacy and safety. J Clin Endocrinol Metab 93:S81–S88
    1. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. 2007. Long-term mortality after gastric bypass surgery. N Engl J Med 357:753–761
    1. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lönroth H, Näslund I, Olbers T, Stenlöf K, Torgerson J, Agren G, Carlsson LM. 2007. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–752
    1. Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I. 2009. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 122:248–256.e245
    1. Pontiroli AE, Morabito A. 2011. Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg 253:484–487
    1. Ashrafian H, Ahmed K, Rowland SP, Patel VM, Gooderham NJ, Holmes E, Darzi A, Athanasiou T. 2011. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer 117:1788–1799
    1. Batsis JA, Romero-Corral A, Collazo-Clavell ML, Sarr MG, Somers VK, Lopez-Jimenez F. 2008. Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study. Mayo Clin Proc 83:897–907
    1. Kremen AJ, Linner JH, Nelson CH. 1954. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg 140:439–448
    1. Mason EE, Ito C. 1967. Gastric bypass in obesity. Surg Clin North Am 47:1345–1351
    1. Miller K, Hell E. 2003. Laparoscopic surgical concepts of morbid obesity. Langenbecks Arch Surg 388:375–384
    1. Nagle A. 2010. Bariatric surgery: a surgeon's perspective. J Am Diet Assoc 110:520–523
    1. Marceau P, Hould FS, Simard S, Lebel S, Bourque RA, Potvin M, Biron S. 1998. Biliopancreatic diversion with duodenal switch. World J Surg 22:947–954
    1. Mognol P, Chosidow D, Marmuse JP. 2005. Laparoscopic sleeve gastrectomy as an initial bariatric operation for high-risk patients: initial results in 10 patients. Obes Surg 15:1030–1033
    1. Nguyen NT, Longoria M, Gelfand DV, Sabio A, Wilson SE. 2005. Staged laparoscopic Roux-en-Y: a novel two-stage bariatric operation as an alternative in the super-obese with massively enlarged liver. Obes Surg 15:1077–1081
    1. Regan JP, Inabnet WB, Gagner M, Pomp A. 2003. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 13:861–864
    1. Catheline JM, Cohen R, Khochtali I, Bihan H, Reach G, Benamouzig R, Benichou J. 2006. [Treatment of super super morbid obesity by sleeve gastrectomy]. Presse Med 35(3 Pt 1):383–387 (French)
    1. Almogy G, Crookes PF, Anthone GJ. 2004. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg 14:492–497
    1. Moy J, Pomp A, Dakin G, Parikh M, Gagner M. 2008. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg 196:e56–e59
    1. Franco JV, Ruiz PA, Palermo M, Gagner M. 2011. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg 21:1458–1468
    1. Heron M, Hoyert DL, Murphy SL, Xu J, Kochanek KD, Tejada-Vera B. 2009. Deaths: final data for 2006. Natl Vital Stat Rep 57:1–134
    1. Rimm EB, Stampfer MJ, Giovannucci E, Ascherio A, Spiegelman D, Colditz GA, Willett WC. 1995. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol 141:1117–1127
    1. Howard BV, Ruotolo G, Robbins DC. 2003. Obesity and dyslipidemia. Endocrinol Metab Clin North Am 32:855–867
    1. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. 2004. Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737
    1. Nguyen NT, Varela E, Sabio A, Tran CL, Stamos M, Wilson SE. 2006. Resolution of hyperlipidemia after laparoscopic Roux-en-Y gastric bypass. J Am Coll Surg 203:24–29
    1. Dixon JB, O'Brien PE. 2002. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care 25:358–363
    1. Zlabek JA, Grimm MS, Larson CJ, Mathiason MA, Lambert PJ, Kothari SN. 2005. The effect of laparoscopic gastric bypass surgery on dyslipidemia in severely obese patients. Surg Obes Relat Dis 1:537–542
    1. Woodard GA, Peraza J, Bravo S, Toplosky L, Hernandez-Boussard T, Morton JM. 2010. One year improvements in cardiovascular risk factors: a comparative trial of laparoscopic Roux-en-Y gastric bypass vs. adjustable gastric banding. Obes Surg 20:578–582
    1. Benaiges D, Goday A, Ramon JM, Hernandez E, Pera M, Cano JF. 2011. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis 7:575–580
    1. Kumar R, Lieske JC, Collazo-Clavell ML, Sarr MG, Olson ER, Vrtiska TJ, Bergstralh EJ, Li X. 2011. Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery 149:654–661
    1. Odstrcil EA, Martinez JG, Santa Ana CA, Xue B, Schneider RE, Steffer KJ, Porter JL, Asplin J, Kuhn JA, Fordtran JS. 2010. The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass. Am J Clin Nutr 92:704–713
    1. Stefater MA, Sandoval DA, Chambers AP, Wilson-Pérez HE, Hofmann SM, Jandacek R, Tso P, Woods SC, Seeley RJ. 2011. Sleeve gastrectomy in rats improves postprandial lipid clearance by reducing intestinal triglyceride secretion. Gastroenterology 141:939–949.e1–4
    1. Wickremesekera K, Miller G, Naotunne TD, Knowles G, Stubbs RS. 2005. Loss of insulin resistance after Roux-en-Y gastric bypass surgery: a time course study. Obes Surg 15:474–481
    1. Rubino F, Gagner M, Gentileschi P, Kini S, Fukuyama S, Feng J, Diamond E. 2004. The early effect of the Roux-en-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. Ann Surg 240:236–242
    1. Rizzello M, Abbatini F, Casella G, Alessandri G, Fantini A, Leonetti F, Basso N. 2010. Early postoperative insulin-resistance changes after sleeve gastrectomy. Obes Surg 20:50–55
    1. Basso N, Capoccia D, Rizzello M, Abbatini F, Mariani P, Maglio C, Coccia F, Borgonuovo G, De Luca ML, Asprino R, Alessandri G, Casella G, Leonetti F. 2011. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis. Surg Endosc 25:3540–3550
    1. Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, Eid GM, Mattar S, Ramanathan R, Barinas-Mitchel E, Rao RH, Kuller L, Kelley D. 2003. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg 238:467–484; discussion 484–485
    1. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM, Dohm L. 1995. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222:339–350; discussion 350–352
    1. Rubino F, R'bibo SL, del Genio F, Mazumdar M, McGraw TE. 2010. Metabolic surgery: the role of the gastrointestinal tract in diabetes mellitus. Nat Rev Endocrinol 6:102–109
    1. Korner J, Inabnet W, Conwell IM, Taveras C, Daud A, Olivero-Rivera L, Restuccia NL, Bessler M. 2006. Differential effects of gastric bypass and banding on circulating gut hormone and leptin levels. Obesity (Silver Spring) 14:1553–1561
    1. Abbatini F, Rizzello M, Casella G, Alessandri G, Capoccia D, Leonetti F, Basso N. 2010. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes. Surg Endosc 24:1005–1010
    1. Chambers AP, Jessen L, Ryan KK, Sisley S, Wilson-Pérez HE, Stefater MA, Gaitonde SG, Sorrell JE, Toure M, Berger J, D'Alessio DA, Woods SC, Seeley RJ, Sandoval DA. 2011. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology 141:950–958
    1. Korner J, Bessler M, Inabnet W, Taveras C, Holst JJ. 2007. Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding. Surg Obes Relat Dis 3:597–601
    1. Laferrère B, Teixeira J, McGinty J, Tran H, Egger JR, Colarusso A, Kovack B, Bawa B, Koshy N, Lee H, Yapp K, Olivan B. 2008. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab 93:2479–2485
    1. Nannipieri M, Mari A, Anselmino M, Baldi S, Barsotti E, Guarino D, Camastra S, Bellini R, Berta RD, Ferrannini E. 2011. The role of β-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab 96:E1372–E1379
    1. Hofsø D, Jenssen T, Bollerslev J, Ueland T, Godang K, Stumvoll M, Sandbu R, Røislien J, Hjelmesæth J. 2011. β-Cell function after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 164:231–238
    1. Lin E, Liang Z, Frediani J, Davis SS, Jr, Sweeney JF, Ziegler TR, Phillips LS, Gletsu-Miller N. 2010. Improvement in ss-cell function in patients with normal and hyperglycemia following Roux-en-Y gastric bypass surgery. Am J Physiol Endocrinol Metab 299:E706–E712
    1. Camastra S, Gastaldelli A, Mari A, Bonuccelli S, Scartabelli G, Frascerra S, Baldi S, Nannipieri M, Rebelos E, Anselmino M, Muscelli E, Ferrannini E. 2011. Early and longer term effects of gastric bypass surgery on tissue-specific insulin sensitivity and β-cell function in morbidly obese patients with and without type 2 diabetes. Diabetologia 54:2093–2102
    1. Lee WJ, Chong K, Ser KH, Chen JC, Lee YC, Chen SC, Su YH, Tsai MH. 2012. C-peptide predicts the remission of type 2 diabetes after bariatric surgery. Obes Surg 22:293–298
    1. Peterli R, Wölnerhanssen B, Peters T, Devaux N, Kern B, Christoffel-Courtin C, Drewe J, von Flüe M, Beglinger C. 2009. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg 250:234–241
    1. Korner J, Bessler M, Cirilo LJ, Conwell IM, Daud A, Restuccia NL, Wardlaw SL. 2005. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin. J Clin Endocrinol Metab 90:359–365
    1. Shin AC, Zheng H, Townsend RL, Sigalet DL, Berthoud HR. 2010. Meal-induced hormone responses in a rat model of Roux-en-Y gastric bypass surgery. Endocrinology 151:1588–1597
    1. Karamanakos SN, Vagenas K, Kalfarentzos F, Alexandrides TK. 2008. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg 247:401–407
    1. Vrang N, Madsen AN, Tang-Christensen M, Hansen G, Larsen PJ. 2006. PYY(3-36) reduces food intake and body weight and improves insulin sensitivity in rodent models of diet-induced obesity. Am J Physiol Regul Integr Comp Physiol 291:R367–R375
    1. Ahrén B, Larsson H, Holst JJ. 1997. Effects of glucagon-like peptide-1 on islet function and insulin sensitivity in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 82:473–478
    1. Stefater MA, Pérez-Tilve D, Chambers AP, Wilson-Pérez HE, Sandoval DA, Berger J, Toure M, Tschöp M, Woods SC, Seeley RJ. 2010. Sleeve gastrectomy induces loss of weight and fat mass in obese rats, but does not affect leptin sensitivity. Gastroenterology 138:2426–2436, 2436.e1–3
    1. Monteiro MP, Ribeiro AH, Nunes AF, Sousa MM, Monteiro JD, Aguas AP, Cardoso MH. 2007. Increase in ghrelin levels after weight loss in obese Zucker rats is prevented by gastric banding. Obes Surg 17:1599–1607
    1. Lee WJ, Chong K, Ser KH, Lee YC, Chen SC, Chen JC, Tsai MH, Chuang LM. 2011. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg 146:143–148
    1. Chambers AP, Stefater MA, Wilson-Perez HE, Jessen L, Sisley S, Ryan KK, Gaitonde S, Sorrell JE, Toure M, Berger J, D'Alessio DA, Sandoval DA, Seeley RJ, Woods SC. Similar effects of roux-en-Y gastric bypass and vertical sleeve gastrectomy on glucose regulation in rats. Physiol Behav 105:120–123
    1. Langer FB, Bohdjalian A, Felberbauer FX, Fleischmann E, Reza Hoda MA, Ludvik B, Zacherl J, Jakesz R, Prager G. 2006. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg 16:166–171
    1. Gumbs AA, Gagner M, Dakin G, Pomp A. 2007. Sleeve gastrectomy for morbid obesity. Obes Surg 17:962–969
    1. Lopez PP, Nicholson SE, Burkhardt GE, Johnson RA, Johnson FK. 2009. Development of a sleeve gastrectomy weight loss model in obese Zucker rats. J Surg Res 157:243–250
    1. Baltasar A, Serra C, Pérez N, Bou R, Bengochea M, Ferri L. 2005. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 15:1124–1128
    1. Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, Bernstine H, Singer P, Dickman R, Beglaibter N, Shikora SA, Rosenthal RJ, Rubin M. 2008. Laparoscopic sleeve gastrectomy: volume and pressure assessment. Obes Surg 18:1083–1088
    1. Melissas J, Koukouraki S, Askoxylakis J, Stathaki M, Daskalakis M, Perisinakis K, Karkavitsas N. 2007. Sleeve gastrectomy: a restrictive procedure? Obes Surg 17:57–62
    1. Gagner M, Rogula T. 2003. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg 13:649–654
    1. Cherian PT, Goussous G, Ashori F, Sigurdsson A. 2010. Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years. Surg Endosc 24:2031–2038
    1. Mittermair RP, Weiss HG, Nehoda H, Peer R, Donnemiller E, Moncayo R, Aigner F. 2003. Band leakage after laparoscopic adjustable gastric banding. Obes Surg 13:913–917
    1. Busetto L, Segato G, De Marchi F, Foletto M, De Luca M, Caniato D, Favretti F, Lise M, Enzi G. 2002. Outcome predictors in morbidly obese recipients of an adjustable gastric band. Obes Surg 12:83–92
    1. Frezza EE, Chiriva-Internati M, Wachtel MS. 2008. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today 38:481–483
    1. Brownlow BS, Park CR, Schwartz RS, Woods SC. 1993. Effect of meal pattern during food restriction on body weight loss and recovery after refeeding. Physiol Behav 53:421–424
    1. Zheng H, Shin AC, Lenard NR, Townsend RL, Patterson LM, Sigalet DL, Berthoud HR. 2009. Meal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery. Am J Physiol Regul Integr Comp Physiol 297:R1273–R1282
    1. Wilson-Pérez H, Chambers AP, Sandoval DA, Stefater MA, Woods SC, Benoit SC, Seeley RJ. 14 February 2012. The effect of vertical sleeve gastrectomy on food choice in rats. Int J Obes (Lond)
    1. Berthoud HR, Powley TL. 1992. Vagal afferent innervation of the rat fundic stomach: Morphological characterization of the gastric tension receptor. J Comp Neurol 319:261–276
    1. Iggo A. 1955. Tension receptors in the stomach and the urinary bladder. J Physiol 128:593–607
    1. Iggo A. 1957. Gastro-intestinal tension receptors with unmyelinated afferent fibres in the vagus of the cat. Q J Exp Physiol Cogn Med Sci 42:130–143
    1. Phillips RJ, Powley TL. 1996. Gastric volume rather than nutrient content inhibits food intake. Am J Physiol 271:R766–R769
    1. Mistiaen W, Vaneerdeweg W, Blockx P, Van Hee R, Hubens G, Bortier H, Harrisson F. 2000. Gastric emptying rate measurement after vertical banded gastroplasty. Obes Surg 10:245–249
    1. de Jong JR, van Ramshorst B, Gooszen HG, Smout AJ, Tiel-Van Buul MM. 2009. Weight loss after laparoscopic adjustable gastric banding is not caused by altered gastric emptying. Obes Surg 19:287–292
    1. Suzuki S, Ramos EJ, Goncalves CG, Chen C, Meguid MM. 2005. Changes in GI hormones and their effect on gastric emptying and transit times after Roux-en-Y gastric bypass in rat model. Surgery 138:283–290
    1. Horowitz M, Collins PJ, Harding PE, Shearman DJ. 1986. Gastric emptying after gastric bypass. Int J Obes 10:117–121
    1. Braghetto I, Davanzo C, Korn O, Csendes A, Valladares H, Herrera E, Gonzalez P, Papapietro K. 2009. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg 19:1515–1521
    1. Shah S, Shah P, Todkar J, Gagner M, Sonar S, Solav S. 2010. Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus. Surg Obes Relat Dis 6:152–157
    1. Bernstine H, Tzioni-Yehoshua R, Groshar D, Beglaibter N, Shikora S, Rosenthal RJ, Rubin M. 2009. Gastric emptying is not affected by sleeve gastrectomy–scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg 19:293–298
    1. Gagner M. 2010. Faster gastric emptying after laparoscopic sleeve gastrectomy. Obes Surg 20:964–965; author reply 966–967
    1. Weigert N, Li YY, Schick RR, Coy DH, Classen M, Schusdziarra V. 1997. Role of vagal fibers and bombesin/gastrin-releasing peptide-neurons in distention-induced gastrin release in rats. Regul Pept 69:33–40
    1. Miranda A, Mickle A, Medda B, Zhang Z, Phillips RJ, Tipnis N, Powley TL, Shaker R, Sengupta JN. 2009. Altered mechanosensitive properties of vagal afferent fibers innervating the stomach following gastric surgery in rats. Neuroscience 162:1299–1306
    1. Schwartz MW, Seeley RJ. 1997. Neuroendocrine responses to starvation and weight loss. N Engl J Med 336:1802–1811
    1. Mizuno TM, Kleopoulos SP, Bergen HT, Roberts JL, Priest CA, Mobbs CV. 1998. Hypothalamic pro-opiomelanocortin mRNA is reduced by fasting and in ob/ob and db/db mice, but is stimulated by leptin. Diabetes 47:294–297
    1. Cheung CC, Clifton DK, Steiner RA. 1997. Proopiomelanocortin neurons are direct targets for leptin in the hypothalamus. Endocrinology 138:4489–4492
    1. Tsujii S, Bray GA. 1989. Acetylation alters the feeding response to MSH and β-endorphin. Brain Res Bull 23:165–169
    1. Fan W, Boston BA, Kesterson RA, Hruby VJ, Cone RD. 1997. Role of melanocortinergic neurons in feeding and the agouti obesity syndrome. Nature 385:165–168
    1. Huszar D, Lynch CA, Fairchild-Huntress V, Dunmore JH, Fang Q, Berkemeier LR, Gu W, Kesterson RA, Boston BA, Cone RD, Smith FJ, Campfield LA, Burn P, Lee F. 1997. Targeted disruption of the melanocortin-4 receptor results in obesity in mice. Cell 88:131–141
    1. Hebebrand J, Volckmar AL, Knoll N, Hinney A. 2010. Chipping away the ‘missing heritability’: GIANT steps forward in the molecular elucidation of obesity - but still lots to go. Obes Facts 3:294–303
    1. Haskell-Luevano C, Monck EK. 2001. Agouti-related protein functions as an inverse agonist at a constitutively active brain melanocortin-4 receptor. Regul Pept 99:1–7
    1. Hagan MM, Rushing PA, Pritchard LM, Schwartz MW, Strack AM, Van Der Ploeg LH, Woods SC, Seeley RJ. 2000. Long-term orexigenic effects of AgRP-(83-132) involve mechanisms other than melanocortin receptor blockade. Am J Physiol 279:R47–R52
    1. Rossi M, Kim MS, Morgan DG, Small CJ, Edwards CM, Sunter D, Abusnana S, Goldstone AP, Russell SH, Stanley SA, Smith DM, Yagaloff K, Ghatei MA, Bloom SR. 1998. A C-terminal fragment of agouti-related protein increases feeding and antagonizes the effect of α-melanocyte stimulating hormone in vivo. Endocrinology 139:4428–4431
    1. Qian S, Chen H, Weingarth D, Trumbauer ME, Novi DE, Guan X, Yu H, Shen Z, Feng Y, Frazier E, Chen A, Camacho RE, Shearman LP, Gopal-Truter S, MacNeil DJ, Van der Ploeg LH, Marsh DJ. 2002. Neither agouti-related protein nor neuropeptide Y is critically required for the regulation of energy homeostasis in mice. Mol Cell Biol 22:5027–5035
    1. Hahn TM, Breininger JF, Baskin DG, Schwartz MW. 1998. Coexpression of Agrp and NPY in fasting-activated hypothalamic neurons. Nat Neurosci 1:271–272
    1. Chen P, Li C, Haskell-Luevano C, Cone RD, Smith MS. 1999. Altered expression of agouti-related protein and its colocalization with neuropeptide Y in the arcuate nucleus of the hypothalamus during lactation. Endocrinology 140:2645–2650
    1. Kishi T, Aschkenasi CJ, Lee CE, Mountjoy KG, Saper CB, Elmquist JK. 2003. Expression of melanocortin 4 receptor mRNA in the central nervous system of the rat. J Comp Neurol 457:213–235
    1. Magenis RE, Smith L, Nadeau JH, Johnson KR, Mountjoy KG, Cone RD. 1994. Mapping of the ACTH, MSH, and neural (MC3 and MC4) melanocortin receptors in the mouse and human. Mamm Genome 5:503–508
    1. Giraudo SQ, Billington CJ, Levine AS. 1998. Feeding effects of hypothalamic injection of melanocortin 4 receptor ligands. Brain Res 809:302–306
    1. Cowley MA, Pronchuk N, Fan W, Dinulescu DM, Colmers WF, Cone RD. 1999. Integration of NPY, AGRP, and melanocortin signals in the hypothalamic paraventricular nucleus: evidence of a cellular basis for the adipostat. Neuron 24:155–163
    1. Wirth MM, Giraudo SQ. 2001. Effect of Agouti-related protein delivered to the dorsomedial nucleus of the hypothalamus on intake of a preferred versus a non-preferred diet. Brain Res 897:169–174
    1. Kask A, Schiöth HB, Mutulis F, Wikberg JE, Rägo L. 2000. Anorexigenic cocaine- and amphetamine-regulated transcript peptide intensifies fear reactions in rats. Brain Res 857:283–285
    1. Adan RA, Tiesjema B, Hillebrand JJ, la Fleur SE, Kas MJ, de Krom M. 2006. The MC4 receptor and control of appetite. Br J Pharmacol 149:815–827
    1. Aslan IR, Campos GM, Calton MA, Evans DS, Merriman RB, Vaisse C. 2011. Weight loss after Roux-en-Y gastric bypass in obese patients heterozygous for MC4R mutations. Obes Surg 21:930–934
    1. Potoczna N, Branson R, Kral JG, Piec G, Steffen R, Ricklin T, Hoehe MR, Lentes KU, Horber FF. 2004. Gene variants and binge eating as predictors of comorbidity and outcome of treatment in severe obesity. J Gastrointest Surg 8:971–981; discussion 981–972
    1. Peterli R, Peters T, von Flüe M, Hoch M, Eberle AN. 2006. Melanocortin-4 receptor gene and complications after gastric banding. Obes Surg 16:189–195
    1. Schwartz A, Doucet E. 2010. Relative changes in resting energy expenditure during weight loss: a systematic review. Obes Rev 11:531–547
    1. Corbett SW, Stern JS, Keesey RE. 1986. Energy expenditure in rats with diet-induced obesity. Am J Clin Nutr 44:173–180
    1. Das SK, Roberts SB, McCrory MA, Hsu LK, Shikora SA, Kehayias JJ, Dallal GE, Saltzman E. 2003. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr 78:22–30
    1. Carrasco F, Papapietro K, Csendes A, Salazar G, Echenique C, Lisboa C, Díaz E, Rojas J. 2007. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obes Surg 17:608–616
    1. Benedetti G, Mingrone G, Marcoccia S, Benedetti M, Giancaterini A, Greco AV, Castagneto M, Gasbarrini G. 2000. Body composition and energy expenditure after weight loss following bariatric surgery. J Am Coll Nutr 19:270–274
    1. Coupaye M, Bouillot JL, Coussieu C, Guy-Grand B, Basdevant A, Oppert JM. 2005. One-year changes in energy expenditure and serum leptin following adjustable gastric banding in obese women. Obes Surg 15:827–833
    1. Kaiyala KJ, Schwartz MW. 2011. Toward a more complete (and less controversial) understanding of energy expenditure and its role in obesity pathogenesis. Diabetes 60:17–23
    1. Bueter M, Löwenstein C, Olbers T, Wang M, Cluny NL, Bloom SR, Sharkey KA, Lutz TA, le Roux CW. 2010. Gastric bypass increases energy expenditure in rats. Gastroenterology 138:1845–1853
    1. Flancbaum L, Choban PS, Bradley LR, Burge JC. 1997. Changes in measured resting energy expenditure after Roux-en-Y gastric bypass for clinically severe obesity. Surgery 122:943–949
    1. Stylopoulos N, Hoppin AG, Kaplan LM. 2009. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring) 17:1839–1847
    1. Guijarro A, Suzuki S, Chen C, Kirchner H, Middleton FA, Nadtochiy S, Brookes PS, Niijima A, Inui A, Meguid MM. 2007. Characterization of weight loss and weight regain mechanisms after Roux-en-Y gastric bypass in rats. Am J Physiol Regul Integr Comp Physiol 293:R1474–R1489
    1. Leibel RL, Rosenbaum M, Hirsch J. 1995. Changes in energy expenditure resulting from altered body weight. N Engl J Med 332:621–628
    1. Korner J, Inabnet W, Febres G, Conwell IM, McMahon DJ, Salas R, Taveras C, Schrope B, Bessler M. 2009. Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass. Int J Obes (Lond) 33:786–795
    1. Woelnerhanssen B, Peterli R, Steinert RE, Peters T, Borbely Y, Beglinger C. 2011. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy-a prospective randomized trial. Surg Obes Relat Dis 7:561–568
    1. DePaula AL, Macedo AL, Schraibman V, Mota BR, Vencio S. 2009. Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 20–34. Surg Endosc 23:1724–1732
    1. Bado A, Levasseur S, Attoub S, Kermorgant S, Laigneau JP, Bortoluzzi MN, Moizo L, Lehy T, Guerre-Millo M, Le Marchand-Brustel Y, Lewin MJ. 1998. The stomach is a source of leptin. Nature 394:790–793
    1. Schultes B, Ernst B, Wilms B, Thurnheer M, Hallschmid M. 2010. Hedonic hunger is increased in severely obese patients and is reduced after gastric bypass surgery. Am J Clin Nutr 92:277–283
    1. Delin CR, Watts JM, Saebel JL, Anderson PG. 1997. Eating behavior and the experience of hunger following gastric bypass surgery for morbid obesity. Obes Surg 7:405–413
    1. Ferrannini E, Mingrone G. 2009. Impact of different bariatric surgical procedures on insulin action and β-cell function in type 2 diabetes. Diabetes Care 32:514–520
    1. Shin AC, Townsend RL, Patterson LM, Berthoud HR. 2011. “Liking” and “wanting” of sweet and oily food stimuli as affected by high-fat diet-induced obesity, weight loss, leptin, and genetic predisposition. Am J Physiol Regul Integr Comp Physiol 301:R1267–R1280
    1. Frederich RC, Hamann A, Anderson S, Löllmann B, Lowell BB, Flier JS. 1995. Leptin levels reflect body lipid content in mice: evidence for diet-induced resistance to leptin action. Nat Med 1:1311–1314
    1. Strader AD, Vahl TP, Jandacek RJ, Woods SC, D'Alessio DA, Seeley RJ. 2005. Weight loss through ileal transposition is accompanied by increased ileal hormone secretion and synthesis in rats. Am J Physiol Endocrinol Metab 288:E447–E453
    1. Masuda T, Ohta M, Hirashita T, Kawano Y, Eguchi H, Yada K, Iwashita Y, Kitano S. 2011. A comparative study of gastric banding and sleeve gastrectomy in an obese diabetic rat model. Obes Surg 21:1774–1780
    1. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. 1999. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 402:656–660
    1. Lai KC, Cheng CH, Leung PS. 2007. The ghrelin system in acinar cells: localization, expression, and regulation in the exocrine pancreas. Pancreas 35:e1–e8
    1. Kirchner H, Gutierrez JA, Solenberg PJ, Pfluger PT, Czyzyk TA, Willency JA, Schürmann A, Joost HG, Jandacek RJ, Hale JE, Heiman ML, Tschöp MH. 2009. GOAT links dietary lipids with the endocrine control of energy balance. Nat Med 15:741–745
    1. Wren AM, Small CJ, Ward HL, Murphy KG, Dakin CL, Taheri S, Kennedy AR, Roberts GH, Morgan DG, Ghatei MA, Bloom SR. 2000. The novel hypothalamic peptide ghrelin stimulates food intake and growth hormone secretion. Endocrinology 141:4325–4328
    1. Tschöp M, Smiley DL, Heiman ML. 2000. Ghrelin induces adiposity in rodents. Nature 407:908–913
    1. Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, Dhillo WS, Ghatei MA, Bloom SR. 2001. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 86:5992.
    1. Langlois F, Langlois MF, Carpentier AC, Brown C, Lemieux S, Hivert MF. 2011. Ghrelin levels are associated with hunger as measured by the Three-Factor Eating Questionnaire in healthy young adults. Physiol Behav 104:373–377
    1. Ariyasu H, Takaya K, Tagami T, Ogawa Y, Hosoda K, Akamizu T, Suda M, Koh T, Natsui K, Toyooka S, Shirakami G, Usui T, Shimatsu A, Doi K, Hosoda H, Kojima M, Kangawa K, Nakao K. 2001. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab 86:4753–4758
    1. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, Gfrerer L, Ludvik B, Zacherl J, Prager G. 2010. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg 20:535–540
    1. Langer FB, Reza Hoda MA, Bohdjalian A, Felberbauer FX, Zacherl J, Wenzl E, Schindler K, Luger A, Ludvik B, Prager G. 2005. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 15:1024–1029
    1. Wang Y, Yan L, Jin Z, Xin X. 2011. Effects of sleeve gastrectomy in neonatally streptozotocin-induced diabetic rats. PLoS One 6:e16383.
    1. Wang Y, Liu J. 2009. Plasma ghrelin modulation in gastric band operation and sleeve gastrectomy. Obes Surg 19:357–362
    1. Li F, Zhang G, Liang J, Ding X, Cheng Z, Hu S. 2009. Sleeve gastrectomy provides a better control of diabetes by decreasing ghrelin in the diabetic Goto-Kakizaki rats. J Gastrointest Surg 13:2302–2308
    1. Busetto L, Segato G, De Luca M, Foletto M, Pigozzo S, Favretti F, Enzi G. 2006. High ghrelin concentration is not a predictor of less weight loss in morbidly obese women treated with laparoscopic adjustable gastric banding. Obes Surg 16:1068–1074
    1. Pournaras DJ, le Roux CW. 2009. Obesity, gut hormones, and bariatric surgery. World J Surg 33:1983–1988
    1. Tymitz K, Engel A, McDonough S, Hendy MP, Kerlakian G. 2011. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg 21:125–130
    1. Lee H, Te C, Koshy S, Teixeira JA, Pi-Sunyer FX, Laferrère B. 2006. Does ghrelin really matter after bariatric surgery? Surg Obes Relat Dis 2:538–548
    1. Drazen DL, Vahl TP, D'Alessio DA, Seeley RJ, Woods SC. 2006. Effects of a fixed meal pattern on ghrelin secretion: evidence for a learned response independent of nutrient status. Endocrinology 147:23–30
    1. Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ. 2002. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 346:1623–1630
    1. Liu J, Prudom CE, Nass R, Pezzoli SS, Oliveri MC, Johnson ML, Veldhuis P, Gordon DA, Howard AD, Witcher DR, Geysen HM, Gaylinn BD, Thorner MO. 2008. Novel ghrelin assays provide evidence for independent regulation of ghrelin acylation and secretion in healthy young men. J Clin Endocrinol Metab 93:1980–1987
    1. Blatnik M, Soderstrom CI. A practical guide for the stabilization of acylghrelin in human blood collections. Clin Endocrinol (Oxf) 74:325–331
    1. Patrikakos P, Toutouzas KG, Gazouli M, Perrea D, Menenakos E, Papadopoulos S, Zografos G. Long-term plasma ghrelin and leptin modulation after sleeve gastrectomy in Wistar rats in comparison with gastric tissue ghrelin expression. Obes Surg 21:1432–1437
    1. Whitson BA, Leslie DB, Kellogg TA, Maddaus MA, Buchwald H, Billington CJ, Ikramuddin S. 2007. Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study. J Surg Res 141:31–39
    1. Whitson BA, Leslie DB, Kellogg TA, Maddaus MA, Buchwald H, Billington CJ, Ikramuddin S. 2007. Adipokine response in diabetics and nondiabetics following the Roux-en-Y gastric bypass: a preliminary study. J Surg Res 142:295–300
    1. Polak JM, Bloom SR, Rayford PL, Pearse AG, Buchan AM, Thompson JC. 1975. Identification of cholecystokinin-secreting cells. Lancet 2:1016–1018
    1. Lewis LD, Williams JA. 1990. Regulation of cholecystokinin secretion by food, hormones, and neural pathways in the rat. Am J Physiol 258:G512–G518
    1. Douglas BR, Jansen JB, de Jong AJ, Lamers CB. 1990. Effect of various triglycerides on plasma cholecystokinin levels in rats. J Nutr 120:686–690
    1. Koop I, Ruppert-Seipp G, Koop H, Schafmayer A, Arnold R. 1990. Cholecystokinin release by gastric distension: an atropine-sensitive mechanism. Digestion 46:220–227
    1. Gibbs J, Young RC, Smith GP. 1973. Cholecystokinin decreases food intake in rats. J Comp Physiol Psychol 84:488–495
    1. Inoue K, Fuchigami A, Hosotani R, Kogire M, Huang YS, Miyashita T, Suzuki T, Tsuda K, Seino Y, Rayford PL, Thompson JC, Tobe T. 1987. Release of cholecystokinin and gallbladder contraction before and after gastrectomy. Ann Surg 205:27–32
    1. Friess H, Böhm J, Müller MW, Glasbrenner B, Riepl RL, Malfertheiner P, Büchler MW. 1996. Maldigestion after total gastrectomy is associated with pancreatic insufficiency. Am J Gastroenterol 91:341–347
    1. Büchler M, Malfertheiner P, Friess H, Nustede R, Feurle GE, Beger HG. 1989. Cholecystokinin influences pancreatic trophism following total gastrectomy in rats. Int J Pancreatol 4:261–271
    1. Zittel TT, von Elm B, Teichmann RK, Rabould HE, Becker HD. 1995. Cholecystokinin is partly responsible for reduced food intake and body weight loss after total gastrectomy in rats. Am J Surg 169:265–270
    1. Zittel TT, Glatzle J, Müller M, Kreis ME, Raybould HE, Becker HD, Jehle EC. 2002. Total gastrectomy severely alters the central regulation of food intake in rats. Ann Surg 236:166–176
    1. Kellum JM, Kuemmerle JF, O'Dorisio TM, Rayford P, Martin D, Engle K, Wolf L, Sugerman HJ. 1990. Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty. Ann Surg 211:763–770; discussion 770–761
    1. Hajnal A, Kovacs P, Ahmed T, Meirelles K, Lynch CJ, Cooney RN. 2010. Gastric bypass surgery alters behavioral and neural taste functions for sweet taste in obese rats. Am J Physiol Gastrointest Liver Physiol 299:G967–G979
    1. Watanabe Y, Kawai K, Ohashi S, Yokota C, Suzuki S, Yamashita K. 1994. Structure-activity relationships of glucagon-like peptide-1(7-36)amide: insulinotropic activities in perfused rat pancreases, and receptor binding and cyclic AMP production in RINm5F cells. J Endocrinol 140:45–52
    1. Wettergren A, Schjoldager B, Mortensen PE, Myhre J, Christiansen J, Holst JJ. 1993. Truncated GLP-1 (proglucagon 78-107-amide) inhibits gastric and pancreatic functions in man. Dig Dis Sci 38:665–673
    1. O'Halloran DJ, Nikou GC, Kreymann B, Ghatei MA, Bloom SR. 1990. Glucagon-like peptide-1 (7-36)-NH2: a physiological inhibitor of gastric acid secretion in man. J Endocrinol 126:169–173
    1. Komatsu R, Matsuyama T, Namba M, Watanabe N, Itoh H, Kono N, Tarui S. 1989. Glucagonostatic and insulinotropic action of glucagonlike peptide I-(7-36)-amide. Diabetes 38:902–905
    1. Hvidberg A, Nielsen MT, Hilsted J, Orskov C, Holst JJ. 1994. Effect of glucagon-like peptide-1 (proglucagon 78-107amide) on hepatic glucose production in healthy man. Metabolism 43:104–108
    1. Turton MD, O'Shea D, Gunn I, Beak SA, Edwards CM, Meeran K, Choi SJ, Taylor GM, Heath MM, Lambert PD, Wilding JP, Smith DM, Ghatei MA, Herbert J, Bloom SR. 1996. A role for glucagon-like peptide-1 in the central regulation of feeding. Nature 379:69–72
    1. Clements RH, Gonzalez QH, Long CI, Wittert G, Laws HL. 2004. Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. Am Surg 70:1–4; discussion 4–5
    1. Cummings DE, Overduin J, Shannon MH, Foster-Schubert KE. 2005. Hormonal mechanisms of weight loss and diabetes resolution after bariatric surgery. Surg Obes Relat Dis 1:358–368
    1. Mason EE. 1999. Ileal [correction of ilial] transposition and enteroglucagon/GLP-1 in obesity (and diabetic?) surgery. Obes Surg 9:223–228
    1. le Roux CW, Aylwin SJ, Batterham RL, Borg CM, Coyle F, Prasad V, Shurey S, Ghatei MA, Patel AG, Bloom SR. 2006. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg 243:108–114
    1. Valderas JP, Irribarra V, Rubio L, Boza C, Escalona M, Liberona Y, Matamala A, Maiz A. 2011. Effects of sleeve gastrectomy and medical treatment for obesity on glucagon-like peptide 1 levels and glucose homeostasis in non-diabetic subjects. Obes Surg 21:902–909
    1. Bode B. 2011. Liraglutide: a review of the first once-daily GLP-1 receptor agonist. Am J Manag Care 17:S59–S70
    1. Adrian TE, Savage AP, Sagor GR, Allen JM, Bacarese-Hamilton AJ, Tatemoto K, Polak JM, Bloom SR. 1985. Effect of peptide YY on gastric, pancreatic, and biliary function in humans. Gastroenterology 89:494–499
    1. Batterham RL, Cowley MA, Small CJ, Herzog H, Cohen MA, Dakin CL, Wren AM, Brynes AE, Low MJ, Ghatei MA, Cone RD, Bloom SR. 2002. Gut hormone PYY(3-36) physiologically inhibits food intake. Nature 418:650–654
    1. Chelikani PK, Haver AC, Reidelberger RD. 2004. Comparison of the inhibitory effects of PYY(3-36) and PYY(1-36) on gastric emptying in rats. Am J Physiol Regul Integr Comp Physiol 287:R1064–R1070
    1. Pfluger PT, Kampe J, Castaneda TR, Vahl T, D'Alessio DA, Kruthaupt T, Benoit SC, Cuntz U, Rochlitz HJ, Moehlig M, Pfeiffer AF, Koebnick C, Weickert MO, Otto B, Spranger J, Tschöp MH. 2007. Effect of human body weight changes on circulating levels of peptide YY and peptide YY3-36. J Clin Endocrinol Metab 92:583–588
    1. Boey D, Lin S, Karl T, Baldock P, Lee N, Enriquez R, Couzens M, Slack K, Dallmann R, Sainsbury A, Herzog H. 2006. Peptide YY ablation in mice leads to the development of hyperinsulinaemia and obesity. Diabetologia 49:1360–1370
    1. Batterham RL, Heffron H, Kapoor S, Chivers JE, Chandarana K, Herzog H, Le Roux CW, Thomas EL, Bell JD, Withers DJ. 2006. Critical role for peptide YY in protein-mediated satiation and body-weight regulation. Cell Metab 4:223–233
    1. Borg CM, le Roux CW, Ghatei MA, Bloom SR, Patel AG, Aylwin SJ. 2006. Progressive rise in gut hormone levels after Roux-en-Y gastric bypass suggests gut adaptation and explains altered satiety. Br J Surg 93:210–215
    1. Chandarana K, Gelegen C, Karra E, Choudhury AI, Drew ME, Fauveau V, Viollet B, Andreelli F, Withers DJ, Batterham RL. 2011. Diet and gastrointestinal bypass-induced weight loss: the roles of ghrelin and peptide YY. Diabetes 60:810–818
    1. Meguid MM, Glade MJ, Middleton FA. 2008. Weight regain after Roux-en-Y: a significant 20% complication related to PYY. Nutrition 24:832–842
    1. Troy S, Soty M, Ribeiro L, Laval L, Migrenne S, Fioramonti X, Pillot B, Fauveau V, Aubert R, Viollet B, Foretz M, Leclerc J, Duchampt A, Zitoun C, Thorens B, Magnan C, Mithieux G, Andreelli F. 2008. Intestinal gluconeogenesis is a key factor for early metabolic changes after gastric bypass but not after gastric lap-band in mice. Cell Metab 8:201–211
    1. Previs SF, Brunengraber DZ, Brunengraber H. 2009. Is there glucose production outside of the liver and kidney? Annu Rev Nutr 29:43–57
    1. Nakatani H, Kasama K, Oshiro T, Watanabe M, Hirose H, Itoh H. 2009. Serum bile acid along with plasma incretins and serum high-molecular weight adiponectin levels are increased after bariatric surgery. Metabolism 58:1400–1407
    1. Parks DJ, Blanchard SG, Bledsoe RK, Chandra G, Consler TG, Kliewer SA, Stimmel JB, Willson TM, Zavacki AM, Moore DD, Lehmann JM. 1999. Bile acids: natural ligands for an orphan nuclear receptor. Science 284:1365–1368
    1. Kohli R, Kirby M, Xanthakos SA, Softic S, Feldstein AE, Saxena V, Tang PH, Miles L, Miles MV, Balistreri WF, Woods SC, Seeley RJ. 2010. High-fructose, medium chain trans fat diet induces liver fibrosis and elevates plasma coenzyme Q9 in a novel murine model of obesity and nonalcoholic steatohepatitis. Hepatology 52:934–944
    1. Cummings BP, Strader AD, Stanhope KL, Graham JL, Lee J, Raybould HE, Baskin DG, Havel PJ. 2010. Ileal interposition surgery improves glucose and lipid metabolism and delays diabetes onset in the UCD-T2DM rat. Gastroenterology 138:2437–2446, 2446.e1
    1. Thomas C, Gioiello A, Noriega L, Strehle A, Oury J, Rizzo G, Macchiarulo A, Yamamoto H, Mataki C, Pruzanski M, Pellicciari R, Auwerx J, Schoonjans K. 2009. TGR5-mediated bile acid sensing controls glucose homeostasis. Cell Metab 10:167–177
    1. Patti ME, Houten SM, Bianco AC, Bernier R, Larsen PR, Holst JJ, Badman MK, Maratos-Flier E, Mun EC, Pihlajamaki J, Auwerx J, Goldfine AB. 2009. Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity (Silver Spring) 17:1671–1677
    1. Bobbioni-Harsch E, Huber O, Morel P, Chassot G, Lehmann T, Volery M, Chliamovitch E, Muggler C, Golay A. 2002. Factors influencing energy intake and body weight loss after gastric bypass. Eur J Clin Nutr 56:551–556
    1. Dias MC, Ribeiro AG, Scabim VM, Faintuch J, Zilberstein B, Gama-Rodrigues JJ. 2006. Dietary intake of female bariatric patients after anti-obesity gastroplasty. Clinics (Sao Paulo) 61:93–98
    1. Wardé-Kamar J, Rogers M, Flancbaum L, Laferrère B. 2004. Calorie intake and meal patterns up to 4 years after Roux-en-Y gastric bypass surgery. Obes Surg 14:1070–1079
    1. Moize V, Geliebter A, Gluck ME, Yahav E, Lorence M, Colarusso T, Drake V, Flancbaum L. 2003. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg 13:23–28
    1. Trostler N, Mann A, Zilberbush N, Charuzi II, Avinoach E. 1995. Nutrient intake following vertical banded gastroplasty or gastric bypass. Obes Surg 5:403–410
    1. Näslund I, Järnmark I, Andersson H. 1988. Dietary intake before and after gastric bypass and gastroplasty for morbid obesity in women. Int J Obes 12:503–513
    1. Brolin RL, Robertson LB, Kenler HA, Cody RP. 1994. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg 220:782–790
    1. Klesges RC, Eck LH, Ray JW. 1995. Who underreports dietary intake in a dietary recall? Evidence from the Second National Health and Nutrition Examination Survey. J Consult Clin Psychol 63:438–444
    1. Zhang J, Temme EH, Sasaki S, Kesteloot H. 2000. Under- and overreporting of energy intake using urinary cations as biomarkers: relation to body mass index. Am J Epidemiol 152:453–462
    1. Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Spitz AF, Apovian CM, Livingston EH, Brolin R, Sarwer DB, Anderson WA, Dixon J, Guven S. 2009. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic, Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver Spring) [Erratum (2010) 18:649] 17(Suppl 1):S1–S70, v
    1. Parkes E. 2006. Nutritional management of patients after bariatric surgery. Am J Med Sci 331:207–213
    1. Kenler HA, Brolin RE, Cody RP. 1990. Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr 52:87–92
    1. Lindroos AK, Lissner L, Sjöström L. 1996. Weight change in relation to intake of sugar and sweet foods before and after weight reducing gastric surgery. Int J Obes Relat Metab Disord 20:634–643
    1. Thomas JR, Marcus E. 2008. High and low fat food selection with reported frequency intolerance following Roux-en-Y gastric bypass. Obes Surg 18:282–287
    1. Halmi KA, Mason E, Falk JR, Stunkard A. 1981. Appetitive behavior after gastric bypass for obesity. Int J Obes 5:457–464
    1. Ernst B, Thurnheer M, Wilms B, Schultes B. 2009. Differential changes in dietary habits after gastric bypass versus gastric banding operations. Obes Surg 19:274–280
    1. Olbers T, Björkman S, Lindroos A, Maleckas A, Lönn L, Sjöström L, Lönroth H. 2006. Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg 244:715–722
    1. Shin AC, Zheng H, Pistell PJ, Berthoud HR. 2011. Roux-en-Y gastric bypass surgery changes food reward in rats. Int J Obes (Lond) 35:642–651
    1. Le Roux CW, Bueter M, Theis N, Werling M, Ashrafian H, Lowenstein C, Athanasiou T, Bloom SR, Spector AC, Olbers T, Lutz TA. 2011. Gastric bypass reduces fat intake and preference. Am J Physiol Regul Integr Comp Physiol 301:R1057–R1066
    1. Hudson SM, Dixon JB, O'Brien PE. 2002. Sweet eating is not a predictor of outcome after Lap-Band placement. Can we finally bury the myth? Obes Surg 12:789–794
    1. Himpens J, Dapri G, Cadière GB. 2006. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16:1450–1456
    1. Shai I, Henkin Y, Weitzman S, Levi I. 2002. Long-term dietary changes after vertical banded gastroplasty: is the trade-off favorable? Obes Surg 12:805–811
    1. Abell TL, Minocha A. 2006. Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci 331:214–218
    1. Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R. 2009. Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol 6:583–590
    1. Ward M, Prachand V. 2009. Surgical treatment of obesity. Gastrointest Endosc 70:985–990
    1. Mallory GN, Macgregor AM, Rand CS. 1996. The influence of dumping on weight loss after gastric restrictive surgery for morbid obesity. Obes Surg 6:474–478
    1. Alamo Alamo M, Sepulveda Torres C, Zapata Perez L. 2006. Vertical isolated gastroplasty with gastro-enteral bypass: preliminary results. Obes Surg 16:353–358
    1. Iannelli A, Dainese R, Piche T, Facchiano E, Gugenheim J. 2008. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol 14:821–827
    1. Snyder-Marlow G, Taylor D, Lenhard MJ. 2010. Nutrition care for patients undergoing laparoscopic sleeve gastrectomy for weight loss. J Am Diet Assoc 110:600–607
    1. Fuks D, Verhaeghe P, Brehant O, Sabbagh C, Dumont F, Riboulot M, Delcenserie R, Regimbeau JM. 2009. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery 145:106–113
    1. Tzovaras G, Papamargaritis D, Sioka E, Zachari E, Baloyiannis I, Zacharoulis D, Koukoulis G. 2012. Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy. Obes Surg 22:23–28
    1. Broadbent R. 1994. Endoscopically assisted gastric stomal dilation for reflux and vomiting after gastric banding. Obes Surg 4:47–50
    1. Busetto L, Valente P, Pisent C, Segato G, de Marchi F, Favretti F, Lise M, Enzi G. 1996. Eating pattern in the first year following adjustable silicone gastric banding (ASGB) for morbid obesity. Int J Obes Relat Metab Disord 20:539–546
    1. Dargent J. 2008. Isolated food intolerance after adjustable gastric banding: a major cause of long-term band removal. Obes Surg 18:829–832
    1. Suter M, Calmes JM, Paroz A, Giusti V. 2007. A new questionnaire for quick assessment of food tolerance after bariatric surgery. Obes Surg 17:2–8
    1. Schweiger C, Weiss R, Keidar A. 2010. Effect of different bariatric operations on food tolerance and quality of eating. Obes Surg 20:1393–1399
    1. Scruggs DM, Buffington C, Cowan GS., Jr 1994. Taste acuity of the morbidly obese before and after gastric bypass surgery. Obes Surg 4:24–28
    1. Burge JC, Schaumburg JZ, Choban PS, DiSilvestro RA, Flancbaum L. 1995. Changes in patients' taste acuity after Roux-en-Y gastric bypass for clinically severe obesity. J Am Diet Assoc 95:666–670
    1. Tichansky DS, Boughter JD, Jr, Madan AK. 2006. Taste change after laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2:440–444
    1. Tichansky DS, Glatt AR, Madan AK, Harper J, Tokita K, Boughter JD. 2011. Decrease in sweet taste in rats after gastric bypass surgery. Surg Endosc 25:1176–1181
    1. Ochner CN, Kwok Y, Conceição E, Pantazatos SP, Puma LM, Carnell S, Teixeira J, Hirsch J, Geliebter A. 2011. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg 253:502–507
    1. Steele KE, Prokopowicz GP, Schweitzer MA, Magunsuon TH, Lidor AO, Kuwabawa H, Kumar A, Brasic J, Wong DF. 2010. Alterations of central dopamine receptors before and after gastric bypass surgery. Obes Surg 20:369–374
    1. Dunn JP, Cowan RL, Volkow ND, Feurer ID, Li R, Williams DB, Kessler RM, Abumrad NN. 2010. Decreased dopamine type 2 receptor availability after bariatric surgery: Preliminary findings. Brain Res 1350:123–130
    1. Padwal R, Klarenbach S, Wiebe N, Birch D, Karmali S, Manns B, Hazel M, Sharma AM, Tonelli M. 2011. Bariatric surgery: a systematic review and network meta-analysis of randomized trials. Obes Rev 12:602–621
    1. Garcia V. 2010. Comment on: laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding: five years of follow-up. Surg Obes Relat Dis 6:475–476
    1. Lakdawala MA, Bhasker A, Mulchandani D, Goel S, Jain S. 2010. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg 20:1–6

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