Sleeve gastrectomy and Roux-en-Y gastric bypass exhibit differential effects on food preferences, nutrient absorption and energy expenditure in obese rats

Objective: All available treatments directed towards obesity and obesity-related complications are associated with suboptimal effectiveness/invasiveness ratios. Pharmacological, behavioral and lifestyle modification treatments are the least invasive, but also the least effective options, leading to...

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Bibliographic Details
Published in:	International Journal of Obesity Vol. 36; no. 11; pp. 1396 - 1402
Main Authors:	Saeidi, N, Nestoridi, E, Kucharczyk, J, Uygun, M K, Yarmush, M L, Stylopoulos, N
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 01-11-2012 Nature Publishing Group
Subjects:	631/443/319 692/699/2743/393 692/700/565/545 Absorption Analysis of Variance Anatomy Animals bariatric-and-metabolic-surgery-original-article Bioenergetics Biological and medical sciences Body Weight Disease Models, Animal Endocrinology Energy Metabolism Epidemiology Food Food Preferences Gastrectomy Gastric Bypass Gastrointestinal surgery Gastroplasty Health aspects Health Promotion and Disease Prevention Hospitals Internal Medicine Intestinal Absorption Invasiveness Lifestyles Locomotor activity Male Medical sciences Medicine Medicine & Public Health Metabolic Diseases Metabolism Nutrients Obesity Obesity - metabolism Obesity - physiopathology Obesity - surgery Physiology Public Health Rats Rats, Long-Evans Rodents Stomach, duodenum, intestine, rectum, anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Weight control Weight Loss United States United States > US Massachusetts animal models metabolism energy expenditure sleeve gastrectomy gastric bypass metabolic surgery Animal model Rat Bariatric surgery Roux en Y loop Absorption Energetic cost Nutritional status Food Stomach Obesity Nutrition Digestive system Rodentia Nutrition disorder Metabolic diseases Gastrectomy Metabolism Vertebrata Mammalia Treatment Preference Animal Nutrient
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Summary:	Objective: All available treatments directed towards obesity and obesity-related complications are associated with suboptimal effectiveness/invasiveness ratios. Pharmacological, behavioral and lifestyle modification treatments are the least invasive, but also the least effective options, leading to modest weight loss that is difficult to maintain long-term. Gastrointestinal weight loss surgery (GIWLS) is the most effective, leading to >60–70% of excess body weight loss, but also the most invasive treatment available. Sleeve gastrectomy (SGx) and Roux-en-Y gastric bypass (RYGB) are the two most commonly performed GIWLS procedures. The fundamental anatomic difference between SGx and RYGB is that in the former procedure, only the anatomy of the stomach is altered, without surgical reconfiguration of the intestine. Therefore, comparing these two operations provides a unique opportunity to study the ways that different parts of the gastrointestinal (GI) tract contribute to the regulation of physiological processes, such as the regulation of body weight, food intake and metabolism. Design: To explore the physiologic mechanisms of the two procedures, we used rodent models of SGx and RYGB to study the effects of these procedures on body weight, food intake and metabolic function. Results: Both SGx and RYGB induced a significant weight loss that was sustained over the entire study period. SGx-induced weight loss was slightly lower compared with that observed after RYGB. SGx-induced weight loss primarily resulted from a substantial decrease in food intake and a small increase in locomotor activity. In contrast, rats that underwent RYGB exhibited a substantial increase in non-activity-related (resting) energy expenditure and a modest decrease in nutrient absorption. Additionally, while SGx-treated animals retained their preoperative food preferences, RYGB-treated rats experienced a significant alteration in their food preferences. Conclusions: These results indicate a fundamental difference in the mechanisms of weight loss between SGx and RYGB, suggesting that the manipulation of different parts of the GI tract may lead to different physiologic effects. Understanding the differences in the physiologic mechanisms of action of these effective treatment options could help us develop less invasive new treatments against obesity and obesity-related complications.
ISSN:	0307-0565 1476-5497
DOI:	10.1038/ijo.2012.167