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Gut hormones influence control over eating after gastric bypass surgery
Gastrointestinal hormones play a role in the control of food intake after Roux-en-Y gastric bypass, but they do not necessarily influence increased eating seen in patients with poor weight-loss maintenance after surgery, according to research in The Journal of Clinical Endocrinology & Metabolism.
Ana de Hollanda, MD, of the obesity unit at Hospital Clinic Universitari in Barcelona, Spain, and colleagues analyzed glucagon-like peptide-1, peptide YY (PYY) and ghrelin responses after a standard mixed liquid meal in adults who had roux-en-Y gastric bypass between 2005 and 2009 resulting in either good weight loss (n = 32) or poor weight-loss maintenance (n = 22). In a second study, researchers analyzed food intake after a blockade of hormonal gut secretion (100 µg octreotide injection vs. saline solution injection, performed on two separate occasions 7 to 10 days apart) in 23 of the adults with good weight loss and 19 of the adults with poor weight-loss maintenance. In a third study, researchers analyzed hormonal response in 14 of the poor weight-loss maintenance participants and 11 controls with obesity, but no surgery, after a very low-calorie, semiliquid diet for 6 weeks (medical checkups were performed weekly).
In the first study, researchers found that fasting GLP-1 and PYY did not differ between the two groups, but fasting ghrelin was lower in the poor weight-loss maintenance group. On saline-infusion day in the second study, food intake in the good weight-loss group was less than the poor weight-loss maintenance group; octreotide injection resulted in a larger food intake in both groups, but the overall difference in food intake between groups remained (P < .001).
In the third study, researchers found ghrelin suppression in the poor weight-loss maintenance group after the low-calorie diet, but no changes in either GLP-1 or PYY.
“Our data show [gastrointestinal] hormones play a role in the control of [food intake] following [roux-en-Y gastric bypass] during a laboratory test meal paradigm,” the researchers wrote. “However, our data do not support, under these experimental conditions, changes in GLP-1, PYY or ghrelin play a major role as determinants of larger [food intake] in subjects with [poor weight-loss maintenance] after [roux-en-Y gastric bypass] surgery. Thus, further studies are warranted to disentangle the mechanisms underpinning the different trajectories encompassed in the variable [weight loss] after [roux-en-Y gastric bypass].” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.