title: The Physiology and Molecular Underpinnings of the Effects of Bariatric Surgery on Obesity and Diabetes.
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.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109; email: ssevers@med.umich.edu.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Evers
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109; email: ssevers@med.umich.edu.|Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109.
authors.forename: Darleen A
authors.initials: DA
authors.lastname: Sandoval
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109; email: ssevers@med.umich.edu.|Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan 48109.
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Seeley
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods; D003920:Diabetes Mellitus / Q000503:physiopathology* / Q000601:surgery*; D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D009765:Obesity / Q000503:physiopathology* / Q000601:surgery*; D015431:Weight Loss / Q000502:physiology
keywords: bariatric surgery; bile acid; glycemic control; gut hormones; microbiota; micronutrients