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The Physiology and Molecular Underpinnings of the Effects of Bariatric Surgery on Obesity and Diabetes

Authors
  • Evers, Simon S.
  • Sandoval, Darleen A.
  • Seeley, Randy J.
Type
Published Article
Journal
Annual Review of Physiology
Publisher
Annual Reviews
Publication Date
Feb 10, 2017
Volume
79
Pages
313–334
Identifiers
DOI: 10.1146/annurev-physiol-022516-034423
Source
Annual Reviews
Keywords
License
Yellow

Abstract

Bariatric surgeries, such as Roux-en-Y gastric bypass and vertical sleeve gastrectomy, produce significant and durable weight loss in both humans and rodents. Recently, these surgical interventions have also been termed metabolic surgery because they result in profound metabolic improvements that often surpass the expected improvement due to body weight loss alone. In this review we focus on the weight-loss independent effects of bariatric surgery, which encompass energy expenditure and macronutrient preference, the luminal composition of the gut (i.e., the microbiota and bile acids), the transformation of the gastrointestinal lining, increases in postprandial gut hormone secretions, glycemic control, pancreas morphology, and micronutrient and mineral absorption. Taken together, these data point to several important physiological changes that contribute to the profound benefits of these surgical procedures. Identifying the underlying molecular mechanisms for these physiological effects will allow better utilization of these existing procedures to help patients and develop new treatments that harness these surgical effects with less invasive interventions.

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