Okay, THIS is interesting...!

[swizzly 901]

First I've ever heard of this...anyone else?

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Gut metabolism changes -- not stomach size -- linked to success of vertical sleeve gastrectomy

Date:March 26, 2014

Source:University of Cincinnati Academic Health Center

Summary: It's not the size of the stomach that causes weight loss after a specific type of bariatric surgery, but rather a change in the gut metabolism, say researchers. They have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced

I

t's not the size of the stomach that causes weight loss after a specific type of bariatric surgery, but rather a change in the gut metabolism, say researchers from the University of Cincinnati (UC), the University of Gothenburg in Sweden and Cincinnati Children's Hospital Medical Center.

The scientists, publishing their results in the March 26, 2014, advanced online edition of Nature, have found that following vertical sleeve gastrectomy, there is a change in bile acids that bind to a nuclear receptor called FXR. In the absence of FXR, the researchers showed, weight-loss success and improvement in diabetes from vertical sleeve gastrectomy is reduced.

Vertical sleeve gastrectomy, VSG, is a bariatric procedure in which approximately 80 percent of the stomach is removed to create a gastric "sleeve," which imposes a physical restriction on the amount of food that can be consumed at one time.

"There are very large debates over how small to make the sleeve," says co-principal investigator Randy Seeley, PhD, professor in the endocrinology, diabetes and metabolism division at UC and director of the Cincinnati Diabetes and Obesity Center. "Conventional thought is when you make the stomach smaller, patients lose more weight because they have less room to put more food and, therefore, eat fewer calories. But as it turns out, the reason why the surgery works is that you are changing the bile acids."

This study, Seeley says, is the first empirical evidence that the therapeutic value of VSG is not a result of the mechanical restriction of a smaller stomach, but the result of increased circulating bile acids that are known to bind to the nuclear receptor FXR.

That discovery, he says, was made in a mouse model by removing the FXR receptor in obese mice that had undergone VSG. Despite having a smaller pouch, or "sleeve," Seeley says, rodents without the FXR receptor didn't lose weight.

Because bile acids and FXR receptors interact with gut microbial communities, the researchers also looked at gut bacteria after VSG. They found that the surgery also results in changes in the gut bacteria.

"Importantly, we observed changes in several key bacterial groups that have been previously linked to the risk of Type 2 diabetes, and these changes were related to FXR and bile acids," says Karen Ryan, PhD, lead author and assistant professor of endocrinology, diabetes and metabolism at UC.

"Manipulating the gut bacteria is another way we think that we might be able to mimic how surgery works without having to do the cutting and stapling," Seeley says.

The significance of this study is in the exploration of future treatments for obesity and Type 2 diabetes, as bariatric surgery is proven to provide substantial improvements in obesity and obesity-related conditions.

"There are not enough surgery tables or surgeons to treat the obesity epidemic, so we need to understand how bariatric surgery works so that we can offer more scalable solutions," Seeley says

Journal Reference:

1. Karen K. Ryan, Valentina Tremaroli, Christoffer Clemmensen, Petia Kovatcheva-Datchary, Andriy Myronovych, Rebekah Karns, Hilary E. Wilson-Pérez, Darleen A. Sandoval, Rohit Kohli, Fredrik Bäckhed, Randy J. Seeley. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature, 2014; DOI: 10.1038/nature13135

[honeyg317 107]

Very interesting! But I have to believe restriction plays a part.

[Danni-doinit4me 140]

Interesting, I have never heard of this either. But I agree with @@honeyg317 I also believe restrictions plays a big role!!

[vogue 310]

Gut bacteria changes huh?? I can't help but think 80% of stomach being gone is a huge player in this game but I also think it's boosted by the use of Probiotics in some manner.

[CowgirlJane 14,259]

Interesting. I have a larger sleeve theoretically as they used 38 (or was in 36?) Bougie and I have had great success. Lost 150 in 14 months....lost another 10 later and have been maintaining.

[MichiganChic 3,262]

I also have a 36 bougie, and I've lost 140 pounds. I can also eat a much larger volume now. However - there are no two ways about it, my overall calorie consumption is much less than before surgery. I think the restriction has to play a part, but I'm sure that's not all it is, since I couldn't seem to lose on a restricted diet before surgery. I just always thought I didn't stick with it long enough, but now I'm not so sure.

[feedyoureye 3,087]

Some of the most forward and promising research on weight gain/loss has to do with the gut biome/microbial system. This is just one more bit of research. I am going to move this to the research forums here. Other bits of this kind of research is posted there and I think I put some in the 5:2 info links in the

Vets forum if you are interested.

[Georgia 2,908]

Some of the most forward and promising research on weight gain/loss has to do with the gut biome/microbial system. This is just one more bit of research. I am going to move this to the research forums here. Other bits of this kind of research is posted there and I think I put some in the 5:2 info links in the Vets forum if you are interested.

I'm interested in " adding to" or guaranteeing continued success with my sleeve. Using knowledge of the gut/biome sounds promising. Refresh my mind as to what you are taking now. I need to get with it.

[feedyoureye 3,087]

I just did a course of antibiotics, so killed off my gut biome... i am now taking a pro biotic in the am and pm for a month... also eating some organic fruits and veggies raw along with cooked. I do not use soap to wash the raw food... just Water if needed. a variety of fibers, cultured foods like pickles, sauerkraut and such...active culture yogurt... the idea is to get a variety of foods to give the biome something good to eat and thrive. Sugar and too much over cooking/processing all the time can really make the biome sick.... so I have read....

[CowgirlJane 14,259]

my NUT told me that probiotic would help with weight loss but I never seriously tried it. Wonder if it makes sense to try during maintenance?

[vogue 310]

my NUT told me that probiotic would help with weight loss but I never seriously tried it. Wonder if it makes sense to try during maintenance?

I credit Probiotics with aiding my weightloss as well as keeping me regular thereby not often needing a laxative. Even those may be directly related. Regular vowel movements = weightloss ?

[greensleeve 457]

I tried to do this, I spent a lot of money on the exact probiotic strains that have been linked with weight loss and it had no effect on me. Maybe if I did it now it might since my diet has completely changed and I'm off diet soda.

I think we need to be very careful. If you get serious live probiotics in powder form or in capsules, I would really talk to your dr first. That's a lot of action going on in a very small stomach.

Maybe reduce the amount they suggest?

[feedyoureye 3,087]

I believe most of the "action" is in the intestines, not the stomach...

[greensleeve 457]

I think you are right about that in terms of where the probiotics work to help us lose weight but I am just afraid that it might be too much bacteria in a small space. I would like to ask someone with experience.

[feedyoureye 3,087]

The bacteria mostly lives and works in the intestine, not the stomach, so it will be ok. It just passes through the stomach.