Much work will be required to determine safety, efficacy, patient selection, etc. There appears to be one strain of obese and diabetic mice that lack receptors for leptin. No humans have been found with such a deficiency. Schachter, in 1967, presented the concept that the difference between severely obese and normal weight patients could be noted at the end of the meal. 7 Severely obese people lack internal cues that provide a feeling of satiety.
Restrictive operations provide a feeling of fullness with a limited amount of food.
This is a mechanical substitution for the missing hormonal effect. The second gene in these recent reports codes for the beta-3 adrenergic receptor. The beta-3 adrenergic receptor is located in visceral fat and the deficiency causes a predisposition to central obesity, insulin resistance and hyperglycemia in mice. If weight is normal, the complications do not occur. But when weight gain occurs, it is visceral in location and diabetes appears.