Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16649
Revised: May 27, 2014
Accepted: June 25, 2014
Published online: November 28, 2014
Processing time: 279 Days and 15.7 Hours
Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures - as diets, physical activity, behavior therapy and pharmacotherapy - have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical.
Core tip: It is important to emphasize the role of the major peptides released by the enteroendocrine system, which promote satiety and modulate energy homeostasis and utilization, as well as those that control fat absorption and intestinal permeability. Bariatric surgery could be the most effective treatment for obesity and co-morbidities, often within days after surgery, independently of weight loss and it is currently the only therapy available for obesity which results in long-term, sustained weight loss. We hypothesize that gut hormones might play a role in induction and long-term maintenance of weight loss, could determine the improvement of obesity-related co-morbidities and could help to identify new drug targets and improved surgical techniques.