August 15, 2014

Weight regain after gastric bypass

Early weight regain after gastric bypass surgery does not reverse metabolic improvements, and the “hunger hormone” ghrelin might indicate who is susceptible to weight regain.


Bariatric surgery, including gastric bypass, is the most effective weight loss approach for obesity. Naji Abumrad, M.D., Robyn Tamboli, Ph.D., and colleagues evaluated whether early weight regain is detrimental to the metabolic improvements that occur after gastric bypass surgery.

The investigators assessed weight, insulin sensitivity and levels of the hormones ghrelin and leptin in patients before and for two years after Roux-en-Y gastric bypass surgery. They found that weight regain occurred in 33 percent of the subjects, but it was not associated with worsening of peripheral or hepatic insulin sensitivity. Subjects with weight regain had higher pre- and post-operative levels of ghrelin, which increases food intake, compared to those who maintained or lost weight after surgery.

The findings, published in the July issue of the journal Obesity, show that early weight regain after gastric bypass does not reverse improvements in insulin sensitivity. Also, higher pre-operative ghrelin levels might identify patients who are more susceptible to weight regain and might benefit from intensive follow-up treatment.

This research was supported by grants from the National Institutes of Health (DK070860, DK091748, TR000445, DK020593, DK059637, DK058404).

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