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How Weight Loss Surgery Affects Hunger Hormones and Metabolism

My last several blogs has concerned how weight loss surgery works.  During the last blog I discussed how we surgery gives us a new smaller stomach.  This week I want to talk about how hunger and satiety are affected by changes in hunger hormones and metabolism. Bariatric surgery can lead to big changes in how our body's hormones and metabolism work to affect our hunger, which are important for losing weight and staying healthy.

Hunger is a complex mechanism with many hormones and processes affecting it. Three hormones in our body that are affected by bariatric surgery include: ghrelin, leptin, and GLP-1. Ghrelin is a hormone that tells our brain when we are hungry. After bariatric surgery the levels of ghrelin decrease. This helps us feel less hungry and can make it easier to eat less and lose weight.

Leptin is another hormone that helps our body know when we have enough energy stored. After bariatric surgery, like gastric bypass, leptin sensitivity can improve. This means our body can better understand when we are full, which can help us eat the right amount of food and maintain a healthy weight.

GLP-1 is a hormone that helps control blood sugar levels and reduce appetite. You may have heard of GLP-1 because  there are new classes of medications that act like GLP-1 and are used to treat diabetes and can help with weight loss. After bariatric surgery levels of GLP-1 increase. This hormone can help our body use insulin and leptin better, making us feel less hungry, which can lead to weight loss and better health.

When we compare bariatric surgeries we see that they affect these hormones in different ways. Gastric sleeve surgery removes a portion of the stomach which produces ghrelin, therefore helps reduce hunger. Gastric bypass, on the other hand, increases the release of GLP-1 after meals, which improve leptin sensitivity and reduce appetite. SADI-S and Duodenal Switch(DS) has similarities to both gastric bypass and sleeve gastrectomy, so can have an additive affect. Plus there are other metabolic changes associated with these two surgeries.  For these reasons we tend to see even more weight loss with SADI-S and DS.

In short, bariatric surgery changes how we experience hunger because of how our hormones and metabolism work. Understanding how surgeries like gastric bypass and sleeve gastrectomy impact hormones like ghrelin, leptin, and GLP-1 is important for helping people with obesity achieve their weight loss goals and improve their overall health. It's essential to consider these hormonal changes when deciding on the best type of surgery for each individual's needs and health goals.