Higher plasma motilin levels in obese patients decrease after Roux-en-Y gastric bypass surgery and regulate hunger.

Area of Science:

• Gastroenterology
• Endocrinology
• Metabolic Research

Background:

• Motilin-induced phase III contractions of the migrating motor complex (MMC) signal hunger in healthy individuals.
• The role of motilin in hunger signaling in obesity and its modulation by bariatric surgery requires further investigation.

Purpose of the Study:

• To investigate the role of motilin as a hunger-inducing factor in obese patients.
• To evaluate the effect of Roux-en-Y gastric bypass (RYGB) surgery on plasma motilin levels and hunger scores in obese individuals.

Main Methods:

• Plasma motilin and ghrelin levels were measured during a complete MMC cycle in controls and obese patients before and after RYGB surgery.
• Hunger scores were recorded, and hedonic hunger was assessed using the Power of Food Scale questionnaire.
• The effect of erythromycin, a motilin agonist, on hunger was evaluated in obese patients.

Main Results:

• Obesity altered phase III origin and was associated with higher plasma motilin levels but a blunted pre-phase III motilin peak, correlating with lower hunger scores.
• Erythromycin administration restored hunger scores in obese patients, indicating motilin's role in hunger.
• RYGB surgery led to decreased motilin levels and reduced hedonic hunger scores, while ghrelin levels remained unchanged.

Conclusions:

• Motilin is implicated in the altered hunger signaling observed in obesity.
• RYGB surgery positively impacts motilin levels and reduces hedonic hunger, suggesting motilin's role in obesity pathogenesis and bariatric surgery outcomes.