Effective weight loss was achieved in morbidly obese patients after undergoing  bariatric surgery .
A substantial majority of patients with diabetes , hyperlipidemia , hypertension , and obstructive sleep apnea experienced complete resolution or improvement
CONTEXT About 5 % of the US population is morbidly obese .
This disease remains largely refractory to diet and drug therapy , but generally responds well to bariatric surgery .
OBJECTIVE To determine the impact of bariatric surgery on weight loss , operative mortality outcome , and 4  obesity  comorbidities ( diabetes , hyperlipidemia , hypertension , and obstructive sleep apnea ) .
Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty.
The purpose of the study was to examine the gastrointestinal hormone responses to meals in morbidly obese patients before and after Roux-en-Y gastric bypass ( GBP ; n = 9 ) or vertical b and ed gastroplasty ( VBG ; n = 7 ) . On consecutive days before and after operation , we measured changes in peripheral blood levels of glucose , insulin , enteroglucagon , serotonin , vasoactive intestinal polypeptide ( VIP ) , and cholecystokinin ( CCK ) in response to a st and ardized glucose or protein-fat meal . The percentage of excess weight lost at 6 months after operation was 66.3 % + /- 4 % and 41.8 % + /- 5 % for GBP and VBG , respectively ( p less than 0.01 ) . The 3-hour integrated glucose response to a glucose meal decreased from 145.3 + /- 33.7 to 75.8 + /- 15.7 g min/L ( p less than 0.02 ) after GBP . This was associated with a decrease in 3-hour integrated insulin response from 22.8 + /- 8.2 to 10.5 + /- 4.9 mU min/L. Vertical b and ed gastroplasty patients had lesser reductions of hyperglycemia and hyperinsulinemia . Neither the CCK , serotonin , nor VIP responses to meals were altered by either operation . The 3-hour integrated enteroglucagon response to glucose increased markedly in GBP patients after operation from 11.8 + /- 6 to 133.4 + /- 38 nmol min/mL ( p less than 0.02 ) . This increase in enteroglucagon occurred at the same time as development of dumping symptoms , which occurred exclusively in GBP patients after glucose but not protein . We conclude that ( 1 ) GBP surgery for morbid obesity results in amelioration of glucose intolerance and hyperinsulinemia , ( 2 ) CCK does not mediate an endocrine satiety effect of surgery , ( 3 ) GBP is associated with an exaggerated enteroglucagon response to glucose , and ( 4 ) enteroglucagon appears to be a marker of the dumping syndrome in GBP patients
Effective weight loss was achieved in morbidly obese patients after undergoing  bariatric surgery .
A substantial majority of patients with diabetes , hyperlipidemia , hypertension , and obstructive sleep apnea experienced complete resolution or improvement
CONTEXT About 5 % of the US population is morbidly obese .
This disease remains largely refractory to diet and drug therapy , but generally responds well to bariatric surgery .
OBJECTIVE To determine the impact of bariatric surgery on weight loss , operative mortality outcome , and 4  obesity  comorbidities ( diabetes , hyperlipidemia , hypertension , and obstructive sleep apnea ) .