Potential gut–brain mechanisms behind adverse mental health outcomes of bariatric surgery
Abstract
Bariatric surgery induces sustained weight loss and metabolic benefits via notable effects on the gut-brain axis that lead to alterations in the neuroendocrine regulation of appetite and glycaemia. However, in a subset of patients, bariatric surgery is associated with adverse effects on mental health, including increased risk of suicide or self-harm as well as the emergence of depression and substance use disorders. The contributing factors behind these adverse effects are not well understood. Accumulating evidence indicates that there are important links between gut-derived hormones, microbial and bile acid profiles, and disorders of mood and substance use, which warrant further exploration in the context of changes in gut-brain signalling after bariatric surgery. Understanding the basis of these adverse effects is essential in order to optimize the health and well-being of people undergoing treatment for obesity.
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Central ghrelin signaling plays a pivotal role in regulating food intake, hippocampal synaptic plasticity and neurogenesis, anxiety, depression, and cognitive function.
“The central ghrelin signaling plays a pivotal role in diverse physiological functions, including the regulation of food intake, hippocampal synaptic plasticity and neurogenesis, anxiety, depression, and cognitive function.”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [549]
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Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases
Loh, J. S., Mak, W. Q., Tan, L. K. S., Ng, C. X., Chan, H. H., Yeow, S. H., Foo, J. B., Ong, Y. S., How, C. W., & Khaw, K. Y. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01743-1 · Cited by 1,193 · see citing works
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Self-citationCare of the Patient After Metabolic and Bariatric Surgery
Bramante, C., Wise, E., & Chaudhry, Z. (2022) · Annals of Internal Medicine · doi:10.7326/aitc202205170 · Cited by 28 · see citing works
- Authors
- Brown, R. M., Guerrero-Hreins, E., Brown, W. A., le Roux, C. W., & Sumithran, P.
- Affiliations
- The University of Melbourne (AU)
- The Alfred Hospital (AU)
- Corresponding author
- Sumithran, Priya
- Venue
- Nature Reviews Endocrinology
- Published
- 2021-07-14
- Volume
- 17
- Issue
- 9
- Pages
- 549-559
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W3182061063
- Cited by
- 49
- References
- 142
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 10 · 2023: 13 · 2022: 7 · 2021: 3
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- bariatric surgery, gut-brain axis, mental health, depression, suicide, self-harm, substance use disorders, gut microbiota, bile acids, obesity, neuroendocrine regulation, appetite, glycemia
- MeSH terms
- Appetite, Mental Disorders, Brain, Cell Communication, Diabetes Mellitus, Type 2, Gastrointestinal Hormones, Humans, Intestines, Neurosecretory Systems, Obesity, Treatment Outcome, Bariatric Surgery
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