Gut Metabolism Changes - Not Stomach Size - Linked to Success of Vertical Sleeve Gastrectomy
Received: 02-Jun-2022 / Manuscript No. JOWT-22-504 / Editor assigned: 03-Jun-2022 / PreQC No. JOWT-22-504 (PQ) / Reviewed: 17-Jun-2022 / QC No. JOWT-22-504 / Revised: 22-Jun-2022 / Manuscript No. JOWT-22-504 (R) / Published Date: 28-Jun-2022 DOI: 10.4172/2165-7904.1000504
It's not the size of the stomach that causes weight loss after a specific type of bariatric surgery, but rather a change in the gut metabolism, say researchers. They have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced [1-5].
About the study
The scientists, publishing their results online, have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced.
Vertical sleeve gastrectomy, VSG, is a bariatric procedure in which approximately 80 percent of the stomach is removed to create a gastric "sleeve," which imposes a physical restriction on the amount of food that can be consumed at one time.
There are very large debates over how small to make the sleeve. Conventional thought is when you make the stomach smaller, patients lose more weight because they have less room to put more food and, therefore, eat fewer calories. But as it turns out, the reason why the surgery works is that you are changing the bile acids.
This study, is the first empirical evidence that the therapeutic value of VSG is not a result of the mechanical restriction of a smaller stomach, but the result of increased circulating bile acids that are known to bind to the nuclear receptor FXR.
That discovery, was made in a mouse model by removing the FXR receptor in obese mice that had undergone VSG. Despite having a smaller pouch, or "sleeve," Seeley says, rodents without the FXR receptor didn't lose weight.
Because bile acids and FXR receptors interact with gut microbial communities, the researchers also looked at gut bacteria after VSG. They found that the surgery also results in changes in the gut bacteria.
Importantly, we observed changes in several key bacterial groups that have been previously linked to the risk of Type 2 diabetes, and these changes were related to FXR and bile acids.
Manipulating the gut bacteria is another way we think that we might be able to mimic how surgery works without having to do the cutting and stapling. The significance of this study is in the exploration of future treatments for obesity and Type 2 diabetes, as bariatric surgery is proven to provide substantial improvements in obesity and obesity-related conditions.
There are not enough surgery tables or surgeons to treat the obesity epidemic, so we need to understand how bariatric surgery works so that we can offer more scalable solutions.
Conflict of Interest
- Chambers AP, Smith EP, Begg DP, Grayson BE, Sisley S, et al. (2014) Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab 306: E424-E432.
- Pournaras DJ, Le Roux CW (2009) The effect of bariatric surgery on gut hormones that alter appetite. Diabetes Metab 35: 508-512.
- Ulker I, Yildiran H (2018) The effects of bariatric surgery on gut microbiota in patients with obesity: a review of the literature. Biosci Microbiota, Food Health pp: 18-018.
- Murphy R, Tsai P, Jüllig M, Liu A, Plank L, et al. (2017) Differential changes in gut microbiota after gastric bypass and sleeve gastrectomy bariatric surgery vary according to diabetes remission. Obes Surg 27: 917-925.
- Arble DM, Sandoval DA, Seeley RJ (2015) Mechanisms underlying weight loss and metabolic improvements in rodent models of bariatric surgery. Diabetologia 58: 211-220.
Citation: Hamuri DA (2022) Gut Metabolism Changes - Not Stomach Size - Linked to Success of Vertical Sleeve Gastrectomy. J Obes Weight Loss Ther 12: 504. DOI: 10.4172/2165-7904.1000504
Copyright: © 2022 Hamuri DA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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