Mechanisms of Action of the Bariatric Procedures

Abstract

Bariatric surgery is the most effective method of sustained long-term weight loss, and it has been extensively proven to ameliorate or resolve most of the associated comorbidities with severe obesity, diabetes included. Traditionally the accepted mechanisms of action of the bariatric procedures were based on the concepts of restriction of calorie intake, malabsorption of nutrients, and a combination of the two. As the close interaction between diet, gut, and brain hormones becomes known, the mechanisms of action of these procedures, as well as their classification, have significantly changed. In fact, it has now become well recognized how the centrally regulated body weight homeostasis is profoundly influenced by hormones secreted in the intestinal tract and adipose tissue. The overall balance of these peripherally secreted hormones and their interaction at the level of the hypothalamus would eventually affect food intake and energy expenditure.