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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| Published in: | International Journal of Obesity Vol. 36; no. 11; pp. 1396 - 1402 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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Nature Publishing Group UK
01-11-2012
Nature Publishing Group |
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| Abstract | 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. |
|---|---|
| AbstractList | 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. 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. 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. 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. 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. International Journal of Obesity (2012) 36, 1396-1402; doi:10.1038/ijo.2012.167; published online 9 October 2012 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. International Journal of Obesity (2012) 36, 1396-1402; doi:10.1038/ijo.2012.167; published online 9 October 2012 Keywords: gastric bypass; metabolism; metabolic surgery; energy expenditure; animal models; sleeve gastrectomy 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. 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. 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. 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. |
| Audience | Academic |
| Author | Nestoridi, E Kucharczyk, J Uygun, M K Yarmush, M L Saeidi, N Stylopoulos, N |
| AuthorAffiliation | 2 Center for Basic and Translational Obesity Research, Division of Endocrinology, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA 1 Center for Engineering in Medicine, Massachusetts General Hospital and Shriners Hospital for Children, Harvard Medical School, Boston, MA, USA |
| AuthorAffiliation_xml | – name: 2 Center for Basic and Translational Obesity Research, Division of Endocrinology, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA – name: 1 Center for Engineering in Medicine, Massachusetts General Hospital and Shriners Hospital for Children, Harvard Medical School, Boston, MA, USA |
| Author_xml | – sequence: 1 givenname: N surname: Saeidi fullname: Saeidi, N organization: Center for Engineering in Medicine, Massachusetts General Hospital and Shriners Hospital for Children, Harvard Medical School, Division of Endocrinology, Center for Basic and Translational Obesity Research, Children’s Hospital Boston, Harvard Medical School – sequence: 2 givenname: E surname: Nestoridi fullname: Nestoridi, E organization: Division of Endocrinology, Center for Basic and Translational Obesity Research, Children’s Hospital Boston, Harvard Medical School – sequence: 3 givenname: J surname: Kucharczyk fullname: Kucharczyk, J organization: Division of Endocrinology, Center for Basic and Translational Obesity Research, Children’s Hospital Boston, Harvard Medical School – sequence: 4 givenname: M K surname: Uygun fullname: Uygun, M K organization: Center for Engineering in Medicine, Massachusetts General Hospital and Shriners Hospital for Children, Harvard Medical School – sequence: 5 givenname: M L surname: Yarmush fullname: Yarmush, M L organization: Center for Engineering in Medicine, Massachusetts General Hospital and Shriners Hospital for Children, Harvard Medical School – sequence: 6 givenname: N surname: Stylopoulos fullname: Stylopoulos, N email: Nicholas.Stylopoulos@childrens.harvard.edu organization: Division of Endocrinology, Center for Basic and Translational Obesity Research, Children’s Hospital Boston, Harvard Medical School |
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| Keywords | 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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| PublicationTitle | International Journal of Obesity |
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| References | EvansSAParsonsADOvertonJMHomeostatic responses to caloric restriction: influence of background metabolic rateJ Appl Physiol200599133613421:STN:280:DC%2BD2MvovFejsg%3D%3D10.1152/japplphysiol.01380.2004 MehranAKoleilatASleeve gastrectomy failure: just when we thought we had the perfect operationBariatric Times201071617 TeskeJAKotzCMEffect of acute and chronic caloric restriction and metabolic glucoprivation on spontaneous physical activity in obesity-prone and obesity-resistant ratsAm J Physiol Regul Integr Comp Physiol2009297R176R1841:CAS:528:DC%2BD1MXovVKiu7Y%3D10.1152/ajpregu.90866.2008 BrolinRLRobertsonLBKenlerHACodyRPWeight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypassAnn Surg19942207827901:STN:280:DyaK2M%2FnslCrsg%3D%3D10.1097/00000658-199412000-00012 ChambersAPJessenLRyanKKSisleySWilson-PerezHEStefaterMAWeight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in ratsGastroenterology20111419509581:CAS:528:DC%2BC3MXhtFSru7rE10.1053/j.gastro.2011.05.050 WeinerRAWeinerSPomhoffIJacobiCMakarewiczWWeigandGLaparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volumeObes Surg2007171297130510.1007/s11695-007-9232-x BueterMLowensteinCOlbersTWangMClunyNLBloomSRGastric bypass increases energy expenditure in ratsGastroenterology20101381845185310.1053/j.gastro.2009.11.012 ShibataHBukowieckiLJRegulatory alterations of daily energy expenditure induced by fasting or overfeeding in unrestrained ratsJ Appl Physiol1987634654701:STN:280:DyaL1c%2FgslWitQ%3D%3D10.1152/jappl.1987.63.2.465 PatrikakosPToutouzasKGGazouliMPerreaDMenenakosEPapadopoulosSLong-term plasma ghrelin and leptin modulation after sleeve gastrectomy in wistar rats in comparison with gastric tissue ghrelin expressionObes Surg2011211432143710.1007/s11695-011-0426-x NestoridiEKvasSKucharczykJStylopoulosNResting energy expenditure and energetic cost of feeding are augmented after Roux-en-Y gastric bypass in Obese MiceEndocrinology2012153223422441:CAS:528:DC%2BC38XmsVKntbk%3D10.1210/en.2011-2041 LowellBBSpiegelmanBMTowards a molecular understanding of adaptive thermogenesisNature20004046526601:CAS:528:DC%2BD3cXis1Grtbk%3D10.1038/35007527 Rao RS, Rao V, Kini S . 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| Snippet | Objective:
All available treatments directed towards obesity and obesity-related complications are associated with suboptimal effectiveness/invasiveness... All available treatments directed towards obesity and obesity-related complications are associated with suboptimal effectiveness/invasiveness ratios.... OBJECTIVE: All available treatments directed towards obesity and obesity-related complications are associated with suboptimal effectiveness/invasiveness... International Journal of Obesity (2012) 36, 1396-1402; doi:10.1038/ijo.2012.167; published online 9 October 2012 |
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| SubjectTerms | 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 |
| Title | Sleeve gastrectomy and Roux-en-Y gastric bypass exhibit differential effects on food preferences, nutrient absorption and energy expenditure in obese rats |
| URI | https://link.springer.com/article/10.1038/ijo.2012.167 https://www.ncbi.nlm.nih.gov/pubmed/23044855 https://www.proquest.com/docview/1151342328 https://pubmed.ncbi.nlm.nih.gov/PMC3651693 |
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