title: The neurohormonal regulation of energy intake in relation to bariatric surgery for obesity.
abstract: Obesity has reached pandemic proportions, with bariatric surgery representing the only currently available treatment demonstrating long-term effectiveness. Over 200,000 bariatric procedures are performed each year in the US alone. Given the reliable and singular success of bariatric procedures, increased attention is being paid to identifying the accompanying neurohormonal changes that may contribute to the resulting decrease in energy intake. Numerous investigations of postsurgical changes in gut peptides have been conducted, suggesting greater alterations in endocrine function in combination restrictive and malabsorptive procedures (e.g., Roux-en-Y gastric bypass) as compared to purely restrictive procedures (e.g., gastric banding), which may contribute to the increased effectiveness of combination procedures. However, very few studies have been performed and relatively little is known about changes in neural activation that may result from bariatric procedures, which likely interact with changes in gut peptides to influence postsurgical caloric intake. This review provides a background in the neurohormonal regulation of energy intake and discusses how differing forms of bariatric surgery may affect the neurohormonal network, with emphasis on Roux-en-Y gastric bypass, the most commonly performed procedure worldwide. The paper represents an invited review by a symposium, award winner or keynote speaker at the Society for the Study of Ingestive Behavior [SSIB] Annual Meeting in Portland, July 2009.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. co2193@columbia.edu
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Ochner
authors.forename: Charlisa
authors.initials: C
authors.lastname: Gibson
authors.forename: Susan
authors.initials: S
authors.lastname: Carnell
authors.forename: Carl
authors.initials: C
authors.lastname: Dambkowski
authors.forename: Allan
authors.initials: A
authors.lastname: Geliebter
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods*; D002149:Energy Intake / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D018377:Neurotransmitter Agents / Q000378:metabolism*; D009765:Obesity / Q000473:pathology / Q000601:surgery*
chemical_list: D018377:Neurotransmitter Agents
references.citation: J Clin Endocrinol Metab. 2008 Jul;93(7):2479-85
references.pmid: 18430778
references.citation: J Surg Res. 2007 Jul;141(1):31-9
references.pmid: 17574036
references.citation: Gastroenterology. 1985 Sep;89(3):494-9
references.pmid: 3839479
references.citation: Physiol Rev. 1986 Jan;66(1):172-234
references.pmid: 2868468
references.citation: Surg Obes Relat Dis. 2005 Sep-Oct;1(5):486-95
references.pmid: 16925275
references.citation: Ann Surg. 2008 Mar;247(3):401-7
references.pmid: 18376181
references.citation: Obes Surg. 2006 Jan;16(1):19-23
references.pmid: 16417752
references.citation: Science. 2003 Aug 22;301(5636):1104-7
references.pmid: 12934011
references.citation: Nature. 2005 Sep 22;437(7058):556-9
references.pmid: 16100511
references.citation: Neuropsychopharmacology. 2010 Jan;35(1):4-26
references.pmid: 19812543
references.citation: Front Neuroendocrinol. 2004 Apr;25(1):27-68
references.pmid: 15183037
references.citation: Int J Obes (Lond). 2009 Apr;33 Suppl 1:S28-32
references.pmid: 19363504
references.citation: Proc Natl Acad Sci U S A. 2007 Nov 13;104(46):18276-9
references.pmid: 17986612
references.citation: Ann Surg. 2006 Jan;243(1):108-14
references.pmid: 16371744
references.citation: J Clin Endocrinol Metab. 2006 May;91(5):1735-40
references.pmid: 16478824
references.citation: Obes Surg. 2005 Mar;15(3):387-97
references.pmid: 15826475
references.citation: Obes Surg. 2009 Feb;19(2):217-229
references.pmid: 18820978
references.citation: Nature. 2007 Nov 1;450(7166):106-9
references.pmid: 17934448
references.citation: Physiol Behav. 2009 Jul 14;97(5):525-30
references.pmid: 19328211
references.citation: Prog Brain Res. 2000;126:39-48
references.pmid: 11105638
references.citation: Am Psychol. 1981 Apr;36(4):361-72
references.pmid: 7023303
references.citation: Neuroimage. 2007 Apr 1;35(2):511-7
references.pmid: 17317222
references.citation: Addict Biol. 2007 Mar;12(1):6-16
references.pmid: 17407492
references.citation: Am J Clin Nutr. 1990 Jul;52(1):87-92
references.pmid: 2360554
references.citation: J Clin Endocrinol Metab. 2005 Feb;90(2):813-9
references.pmid: 15585553
references.citation: Arch Surg. 2004 Jul;139(7):780-4
references.pmid: 15249413
references.citation: Obesity (Silver Spring). 2006 Jun;14 Suppl 3:143S-149S
references.pmid: 16931496
references.citation: Obesity (Silver Spring). 2008 May;16(5):945-50
references.pmid: 18292747
references.citation: J Invest Surg. 2008 Mar-Apr;21(2):77-81
references.pmid: 18340624
references.citation: Am J Clin Nutr. 2006 Oct;84(4):725-31
references.pmid: 17023697
references.citation: Cell Metab. 2008 May;7(5):400-9
references.pmid: 18460331
references.citation: Obes Res. 2004 Jun;12(6):962-71
references.pmid: 15229336
references.citation: Behav Neurosci. 2004 Jun;118(3):479-87
references.pmid: 15174925
references.citation: Neuropsychopharmacology. 2006 Dec;31(12):2728-38
references.pmid: 16598192
references.citation: J Abnorm Psychol. 2008 Nov;117(4):936-40
references.pmid: 19025238
references.citation: J Clin Invest. 1985 Apr;75(4):1144-52
references.pmid: 2580857
references.citation: Int J Obes (Lond). 2009 Jul;33(7):786-95
references.pmid: 19417773
references.citation: Obes Surg. 2004 May;14(5):644-7
references.pmid: 15186632
references.citation: Psychiatry Res. 2000 Jul 10;99(1):29-42
references.pmid: 10891647
references.citation: Science. 2000 Jan 7;287(5450):125-8
references.pmid: 10615045
references.citation: Obes Surg. 2007 Mar;17(3):304-10
references.pmid: 17546836
references.citation: Endocrinology. 2003 Dec;144(12):5172-8
references.pmid: 12970158
references.citation: Obesity (Silver Spring). 2006 Feb;14(2):194-8
references.pmid: 16571843
references.citation: Ann Surg. 2004 Aug;240(2):236-42
references.pmid: 15273546
references.citation: J Gastrointest Surg. 2006 Feb;10(2):270-7
references.pmid: 16455461
references.citation: Am J Physiol Regul Integr Comp Physiol. 2004 Nov;287(5):R1044-53
references.pmid: 15297267
references.citation: Am J Cardiol. 2008 Oct 1;102(7):930-7
references.pmid: 18805125
references.citation: Obes Surg. 2006 May;16(5):651-8
references.pmid: 16687037
references.citation: J Clin Invest. 2008 Jul;118(7):2380-3
references.pmid: 18568083
references.citation: J Clin Endocrinol Metab. 2008 Jun;93(6):2122-8
references.pmid: 18397988
references.citation: Obesity (Silver Spring). 2007 Aug;15(8):2012-8
references.pmid: 17712119
references.citation: Neuroendocrinology. 2004;79(6):317-26
references.pmid: 15256809
references.citation: Appetite. 2004 Dec;43(3):315-7
references.pmid: 15527935
references.citation: Endocrinology. 2009 Jun;150(6):2518-25
references.pmid: 19372197
references.citation: Regul Pept. 1996 Sep 16;65(3):165-74
references.pmid: 8897639
references.citation: Arch Surg. 2003 Apr;138(4):389-96
references.pmid: 12686525
references.citation: Obes Res. 2004 Jul;12(7):1108-16
references.pmid: 15292475
references.citation: Auton Neurosci. 2002 Nov 29;102(1-2):39-44
references.pmid: 12492134
references.citation: Br J Surg. 2006 Feb;93(2):210-5
references.pmid: 16392104
references.citation: J Clin Endocrinol Metab. 2008 Nov;93(11):4276-81
references.pmid: 18713823
references.citation: Peptides. 2003 Apr;24(4):597-602
references.pmid: 12860204
references.citation: Obes Surg. 2004 Oct;14(9):1157-64
references.pmid: 15527627
references.citation: Verh Dtsch Ges Inn Med. 1987;93:443-8
references.pmid: 3327295
references.citation: Obes Surg. 2008 Sep;18(9):1089-96
references.pmid: 18408980
references.citation: Obes Surg. 2005 Sep;15(8):1118-23
references.pmid: 16197782
references.citation: Eat Weight Disord. 2008 Dec;13(4):e96-9
references.pmid: 19169070
references.citation: Child Adolesc Psychiatr Clin N Am. 2009 Jan;18(1):95-115
references.pmid: 19014860
references.citation: J Clin Endocrinol Metab. 2005 Jan;90(1):359-65
references.pmid: 15483088
references.citation: Brain Res. 1995 Dec 8;702(1-2):55-60
references.pmid: 8846096
references.citation: Adv Psychosom Med. 1972;7:173-93
references.pmid: 4566381
references.citation: Obes Surg. 2007 Dec;17(12):1571-7
references.pmid: 18046613
references.citation: Obesity (Silver Spring). 2006 Sep;14(9):1553-61
references.pmid: 17030966
references.citation: Surg Obes Relat Dis. 2005 May-Jun;1(3):358-68
references.pmid: 16925248
references.citation: Nat Rev Neurosci. 2005 Sep;6(9):691-702
references.pmid: 16136173
references.citation: Gastroenterology. 2002 Oct;123(4):1120-8
references.pmid: 12360474
references.citation: N Engl J Med. 2007 Aug 23;357(8):741-52
references.pmid: 17715408
references.citation: Obes Res. 2001 Nov;9(11):676-84
references.pmid: 11707534
references.citation: Obes Surg. 2004 May;14(5):606-12
references.pmid: 15186626
references.citation: Int J Obes Relat Metab Disord. 2002 Apr;26(4):504-9
references.pmid: 12075577
references.citation: Clin Endocrinol (Oxf). 2008 Aug;69(2):173-9
references.pmid: 18167136
references.citation: J Clin Invest. 2006 Dec;116(12):3229-39
references.pmid: 17060947
references.citation: Obes Surg. 2006 Sep;16(9):1189-97
references.pmid: 16989703
references.citation: Eur J Endocrinol. 2008 Feb;158(2):135-45
references.pmid: 18230819
references.citation: Obes Surg. 2004 Oct;14(9):1208-15
references.pmid: 15527636
references.citation: Pharmacol Res. 1992 Oct-Nov;26(3):285-92
references.pmid: 1359523
references.citation: N Engl J Med. 2002 May 23;346(21):1623-30
references.pmid: 12023994
references.citation: Surg Obes Relat Dis. 2006 Jul-Aug;2(4):440-4
references.pmid: 16925376
references.citation: Eur J Clin Invest. 2004 Aug;34(8):549-54
references.pmid: 15305889
references.citation: J Clin Endocrinol Metab. 2004 Jun;89(6):2608-15
references.pmid: 15181031
references.citation: Obes Surg. 2009 Mar;19(3):313-20
references.pmid: 18815849
references.citation: Obes Surg. 2004 Jun-Jul;14(6):783-7
references.pmid: 15318982
references.citation: Physiol Behav. 2009 Jul 14;97(5):551-60
references.pmid: 19328819
references.citation: J Clin Invest. 2008 Jul;118(7):2583-91
references.pmid: 18568078
references.citation: Obes Surg. 2003 Dec;13(6):874-8
references.pmid: 14738674
references.citation: Obes Rev. 2003 Nov;4(4):229-38
references.pmid: 14649373
references.citation: Obes Surg. 2007 Sep;17(9):1159-64
references.pmid: 18074488
references.citation: Physiol Behav. 1992 Dec;52(6):1187-92
references.pmid: 1484878
references.citation: N Engl J Med. 2003 Sep 4;349(10):941-8
references.pmid: 12954742
references.citation: Int J Obes (Lond). 2009 Jun;33(6):653-61
references.pmid: 19365394
references.citation: Surgery. 2005 Aug;138(2):283-90
references.pmid: 16153438
references.citation: Neuropeptides. 2006 Dec;40(6):375-401
references.pmid: 16935329
references.citation: Nat Med. 2002 Jul;8(7):643-4
references.pmid: 12091883
references.citation: Obes Surg. 2008 Nov;18(11):1424-9
references.pmid: 18542849
references.citation: Ann Surg. 2011 Mar;253(3):502-7
references.pmid: 21169809
references.citation: Obesity (Silver Spring). 2008 Feb;16(2):298-305
references.pmid: 18239636
references.citation: Ann Surg. 2009 Aug;250(2):234-41
references.pmid: 19638921
references.citation: Gastroenterology. 2001 Feb;120(3):669-81
references.pmid: 11179243
references.citation: Int J Obes Relat Metab Disord. 2001 Dec;25 Suppl 5:S42-7
references.pmid: 11840214
references.citation: J Gastrointest Surg. 2002 Mar-Apr;6(2):195-203; discussion 204-5
references.pmid: 11992805
references.citation: Obes Res. 2004 Feb;12(2):346-50
references.pmid: 14981228
references.citation: Physiol Behav. 2004 Jul;81(5):781-93
references.pmid: 15234184
references.citation: Auton Neurosci. 2004 Jan 30;110(1):36-43
references.pmid: 14766323
references.citation: Obes Surg. 2002 Jun;12(3):324-7
references.pmid: 12082881
references.citation: Obes Surg. 2008 Sep;18(9):1119-25
references.pmid: 18317853
references.citation: World J Surg. 1998 Sep;22(9):947-54
references.pmid: 9717420
references.citation: J Nutr. 2000 Dec;130(12):3127S-3131S
references.pmid: 11110887
references.citation: Eur J Neurosci. 2004 Sep;20(5):1411-8
references.pmid: 15341613
references.citation: JAMA. 2004 Oct 13;292(14):1724-37
references.pmid: 15479938
references.citation: Endocrinology. 2003 Dec;144(12):5184-7
references.pmid: 14525914
references.citation: Obes Res. 2003 Aug;11(8):919-24
references.pmid: 12917494
references.citation: J Clin Endocrinol Metab. 2003 Apr;88(4):1594-602
references.pmid: 12679444
references.citation: Surg Endosc. 2009 Aug;23(8):1724-32
references.pmid: 18830747
references.citation: Am J Clin Nutr. 2002 Nov;76(5):923-7
references.pmid: 12399261
references.citation: Horm Metab Res. 2000 Feb;32(2):62-5
references.pmid: 10741687
references.citation: Appetite. 2006 Jan;46(1):31-5
references.pmid: 16364498
references.citation: Int J Obes. 1981;5(5):457-64
references.pmid: 7309330
references.citation: Obes Surg. 2009 Oct;19(10):1414-23
references.pmid: 19172368
references.citation: Science. 2007 Sep 7;317(5843):1355
references.pmid: 17690262
references.citation: J Clin Endocrinol Metab. 2003 Jul;88(7):3177-83
references.pmid: 12843162
references.citation: Obes Surg. 2005 Feb;15(2):187-90
references.pmid: 15802059
references.citation: Obes Surg. 2010 Mar;20(3):369-74
references.pmid: 19902317
references.citation: Am J Gastroenterol. 1986 Nov;81(11):1038-42
references.pmid: 3776950
references.citation: Am J Surg. 2006 Nov;192(5):657-62
references.pmid: 17071202
references.citation: J Clin Endocrinol Metab. 2005 Aug;90(8):4521-4
references.pmid: 15914532
references.citation: Diabetes. 2000 May;49(5):838-46
references.pmid: 10905495
references.citation: Proc Nutr Soc. 2005 May;64(2):213-6
references.pmid: 15960866
references.citation: Obes Res. 1998 Sep;6 Suppl 2:51S-209S
references.pmid: 9813653
references.citation: Obesity (Silver Spring). 2008 Dec;16 Suppl 3:S11-22
references.pmid: 19190620
references.citation: Obes Surg. 2006 May;16(5):554-9
references.pmid: 16687021
references.citation: Int J Obes (Lond). 2007 Mar;31(3):440-8
references.pmid: 16819526
references.citation: Int J Obes Relat Metab Disord. 2001 Aug;25(8):1206-14
references.pmid: 11477506
references.citation: Biochem Biophys Res Commun. 2004 Jan 16;313(3):635-41
references.pmid: 14697239
references.citation: Endocrinology. 2005 May;146(5):2369-75
references.pmid: 15718279
references.citation: Brain Res. 1999 Nov 27;848(1-2):114-23
references.pmid: 10612703
references.citation: JAMA. 2002 Dec 11;288(22):2793-6
references.pmid: 12472304
references.citation: Cleve Clin J Med. 2006 Nov;73(11):993-1007
references.pmid: 17128540
references.citation: Diabetes. 2006 Jul;55(7):2025-31
references.pmid: 16804072
references.citation: Diabetes Care. 2009 Mar;32(3):375-80
references.pmid: 19033407
references.citation: Appetite. 2009 Aug;53(1):114-8
references.pmid: 19500623
references.citation: Eur J Neurosci. 2009 Oct;30(8):1625-35
references.pmid: 19811532
references.citation: Physiol Behav. 2006 Mar 30;87(3):487-92
references.pmid: 16442572
references.citation: J Physiol Pharmacol. 1994 Dec;45(4 Suppl 1):3-66
references.pmid: 7787215
references.citation: Regul Pept. 2000 Aug 25;92(1-3):79-85
references.pmid: 11024569
references.citation: Obes Res. 2004 Apr;12(4):684-7
references.pmid: 15090637
references.citation: Ann Surg. 1990 Jun;211(6):763-70; discussion 770-1
references.pmid: 2192696
references.citation: Annu Rev Psychol. 2008;59:55-92
references.pmid: 18154499
references.citation: J Clin Endocrinol Metab. 2006 Nov;91(11):4223-31
references.pmid: 16954156
references.citation: Obes Surg. 2006 Nov;16(11):1425-32
references.pmid: 17132406
references.citation: Physiol Behav. 1989 Apr;45(4):695-704
references.pmid: 2780836
references.citation: BMC Neurosci. 2004 Feb 23;5:5
references.pmid: 15028115
references.citation: Proc Natl Acad Sci U S A. 1997 Sep 16;94(19):10455-60
references.pmid: 9294232
references.citation: Am J Clin Nutr. 2007 Oct;86(4):965-71
references.pmid: 17921372
references.citation: J Clin Endocrinol Metab. 2003 Jul;88(7):2999-3002
references.pmid: 12843132
references.citation: Physiol Behav. 2008 Jan 28;93(1-2):13-9
references.pmid: 17727903
references.citation: J Am Diet Assoc. 1995 Jun;95(6):666-70
references.pmid: 7759742
references.citation: Med Clin North Am. 2007 May;91(3):415-31, x-xi
references.pmid: 17509386