Cited by 276Bariatric Surgery and OutcomesRegulation of Appetite and ObesityMinimally Invasive Surgical Techniques

Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass

Dirksen, C, Jørgensen, N B, Bojsen-Møller, K N, Kielgast, U, Jacobsen, S H, Clausen, T R, Worm, D, Hartmann, B +6 more·2013·International Journal of Obesity

Abstract

Objective To identify factors contributing to the variation in weight loss after Roux-en-Y gastric bypass (RYGB).Design Cross-sectional study of patients with good (excess body mass index lost (EBL) >60%) and poor weight loss response (EBL <50%) >12 months after RYGB and a lean control group matched for age and gender.Materials and methods Sixteen patients with good weight loss response, 17 patients with poor weight loss response, and eight control subjects were included in the study. Participants underwent dual energy X-ray absorptiometry scan, indirect calorimetry and a 9 h multiple-meal test with measurements of glucose, insulin, total bile acids (TBA), glucagon-like peptide (GLP)-1, peptide YY3-36 (PYY), cholecystokinin (CCK), ghrelin, neurotensin and pancreatic polypeptide (PP) as well as assessment of early dumping and appetite.Results Suppression of hunger was more pronounced in the good than the poor responders in response to the multiple-meal test (P=0.006). In addition, the good responders had a larger release of GLP-1 (P=0.009) and a greater suppression of ghrelin (P=0.037) during the test, whereas the postprandial secretion of CCK was highest in the poor responders (P=0.005). PYY, neurotensin, PP and TBA release did not differ between the RYGB-operated groups. Compared with control subjects, patients had exaggerated release of GLP-1 (P<0.001), PYY (P=0.008), CCK (P=0.010) and neurotensin (P<0.001). Early dumping was comparable in the good and poor responders, but more pronounced than in controlled subjects. Differences in resting energy expenditure between the three groups were entirely explained by differences in body composition.Conclusion Favorable meal-induced changes in hunger and gut hormone release in patients with good compared with poor weight loss response support the role of gut hormones in the weight loss after RYGB.

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  • To date, the majority of the literature on weight regain physiology is based on dietary or surgically induced weight loss.

    “To date, the majority of the literature on weight regain physiology is based on dietary or surgically induced weight loss.”

    From The societal implications of using glucagon-like peptide-1 receptor agonists for the treatment of obesity (2025) · cites this paper as [82]

    The Introduction (p. 1) and Discussion (pp. 5–6) address physiological differences in weight-loss response after gastric bypass, not the composition of the literature on weight-regain physiology. Searches for the claimed predominance of dietary or surgically induced weight-loss studies found no passage in our copy that assesses it. (LLM, conf=0.74)

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  • Patients with poor postoperative weight loss have greater concentrations of ghrelin and lower concentrations of GLP-1 and PYY than those with good weight loss.

    “Furthermore, it has been shown that patients with poor postoperative weight loss have greater concentrations of ghrelin and lower concentrations of GLP-1 and PYY than those with good weight loss [126].”

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  1. 30 Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Guven S et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric. Obesity (Silver Spring) 2008; 4 : S109-S184.

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Authors
Dirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Kielgast, U., Jacobsen, S. H., Clausen, T. R., Worm, D., Hartmann, B., Rehfeld, J. F., Damgaard, M., Madsen, J. L., Madsbad, S., Holst, J. J., & Hansen, D. L.
Affiliations
  • University of Copenhagen (DK)
  • Novo Nordisk (Denmark) (DK)
Corresponding author
Dirksen, C
Venue
International Journal of Obesity
Published
2013-02-19
Volume
37
Issue
11
Pages
1452-1459
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
OpenAlex
W2049394141
Cited by
276
References
53
Citations by year
2026: 4 · 2025: 18 · 2024: 16 · 2023: 16 · 2022: 21 · 2021: 25 · 2020: 21 · 2019: 19 · 2018: 24 · 2017: 27 · 2016: 31 · 2015: 30 · 2014: 14 · 2013: 9
FWCI
27.59
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Keywords
Roux-en-Y gastric bypass, weight loss response, gastrointestinal hormones, resting energy expenditure, ghrelin, glucagon-like peptide-1, cholecystokinin, peptide YY, neurotensin, pancreatic polypeptide, total bile acids, appetite suppression, body composition, bariatric surgery
MeSH terms
Appetite Regulation, Bile Acids and Salts, Blood Glucose, Cholecystokinin, Cross-Sectional Studies, Dumping Syndrome, Energy Metabolism, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurotensin, Obesity, Morbid, Gastric Bypass, Weight Loss, Absorptiometry, Photon, Body Mass Index, Treatment Outcome, Peptide YY, Glucagon-Like Peptide 1, Ghrelin

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