Bariatric2010

Bariatric2010 - Mechanism gastric bypass Increased...

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Bariatric Surgery
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Type of bypass
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Exponential increase bypass surgery
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Mortality bariatric surgery
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Causes of death
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Hazard ratios
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Survival by BMI
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Swedish Cause Death
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Swedish weight change by surgery type
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Swedish cumulative mortality
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Swedish mortality causes
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Gut hormones and gastric bypass
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Gut brain connections
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Why gastric bypass works? One element, of course, is the physical limitation of gastric volume, creating discomfort due to distention if patients ingest their habitual quantities of food. If this were the only mechanism involved, patients might respond by eating small amounts frequently and ingesting high-density liquids like milkshakes, which some patients do. But most patients report reductions in appetite that favor weight loss and the maintenance of a reduced weight. What might account for this change in appetite?
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Ghrelin levels vary with meals
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Plasma Ghrelin after bypass
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Nutrient sensing in the alimentary canal and the control of food intake.
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Implications regarding vagal innervation and endocrine functions of gastric bypass surgery.
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Unformatted text preview: Mechanism gastric bypass Increased secretion of PYY336 and GLP-1 from ileal L-cells caused by dumping of nutrients after RYGB is the most plausible explanation for the beneficial effects on glucose homeostasis and suppression of food intake. Although considerable evidence suggests that these two peptides act directly on the brain, vagal afferents may also participate. Thus, the enhanced suppression of food intake after RYGB could be partly mediated by vagal afferents in the celiac and gastroduodenal abdominal branches. These branches should not be damaged by the surgery. A role for vagal efferents in the control of PYY and GLP-1 secretion has also been reported. Conclusions Bariatric surgery works. People lose weight and increase lifespan. Successful weight loss is correlated with decreased appetite. Mechanisms are subject to active research ie unknown. Adipocyte numbers remain stable following the substantial weight loss of surgery....
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This document was uploaded on 01/31/2011.

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Bariatric2010 - Mechanism gastric bypass Increased...

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