Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass
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)
Experimental — accuracy not yet measuredPatients 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].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [126]
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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
- ORCID
- 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
- Licence
- www.springer.com/tdm (tdm)
- 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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