Molecular Target for Sleeve Gastrectomy Effects

natureIn today’s issue of Nature, Randy Seeley and his colleagues have published a mouse study suggesting that, one day, doctors might be able to mimic the beneficial effects of surgery without actually doing the surgery.

That premise will seem crazy to most surgeons, and that’s because the conventional explanation for bariatric surgery’s effectiveness is mechanical. In the two most common procedures (known as Roux-en-Y gastric bypass, and vertical sleeve gastrectomy, or VSG), surgeons make the stomach drastically smaller.

“The common-wisdom explanation is that this is the intestinal equivalent of wiring your jaw shut,” Seeley says. That is: With a much smaller stomach, patients simply can’t absorb as many calories, so they lose weight and the weight-loss cures their diabetes. But Seeley doesn’t think this explanation makes sense. “It’s bologna,” he says.

He points out that, anecdotally, patients don’t feel as hungry after surgery as they used to. What’s more, within days of surgery — long before any substantial weight loss has occurred — many patients show such improvement in blood glucose levels that they can stop taking diabetes medications. All of this suggests that surgery changes not just the structure of the stomach, but its biochemistry.

Read the full story at National Geographic  



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