Gastrointestinal peptides after bariatric surgery and appetite control: are they in tuning?

To discuss the contribution of gut peptides to the improved appetite control that results from obesity surgery.

The treatment options for morbid obesity are few, and bariatric interventions have become a common intervention to treat large excesses in adiposity. The mechanisms explaining the large weight losses and the notable long-term maintenance that characterize bariatric interventions have intrigued researchers for a few decades. One of these mechanisms may entail the altered secretion pattern of appetite-related gut peptides. In fact, an increasing number of studies have highlighted the exaggerated nutrient-stimulated response of some of these anorectic hormones, namely peptide YY and glucagon-like peptide-1, along with a down-regulation of ghrelin, the only orexigenic hormone known in humans. Among most recent findings, a suboptimal gut peptide response was reported in poor responders to bypass surgery. In summary, results currently available have brought us closer to understanding the link between the altered gut peptide secretion and the improved appetite control resulting from obesity surgery.

The surge of literature related to the exaggerated nutrient-stimulated response of gut peptides after bypass intervention provides increasing support for the role of some of these hormones in the long-term success rates of obesity surgery.