Mechanisms of weight loss after obesity surgery

Elina Akalestou, Alexander D Miras, Guy A Rutter, Carel W le Roux

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Obesity surgery remains the most effective treatment for obesity and its complications. Weight loss was initially attributed to decreased energy absorption from the gut but have since been linked to reduced appetitive behaviour and potentially increased energy expenditure. Implicated mechanisms associating rearrangement of the gastrointestinal tract with these metabolic outcomes include central appetite control, release of gut peptides, change in microbiota and bile acids. However, the exact combination and timing of signals remain largely unknown. In this review, we survey recent research investigating these mechanisms, and seek to provide insights on unanswered questions over how weight loss is achieved following bariatric surgery which may eventually lead to safer, nonsurgical weight-loss interventions or combinations of medications with surgery.
Original languageEnglish
JournalEndocrine Reveiws
Early online date7 Aug 2021
Publication statusE-pub ahead of print - 7 Aug 2021


  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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