Ghrelin

Ghrelin is also known as appetite hormone or hunger hormone. It is a peptide hormone produced by the cells forming the lining of the stomach and in epsilon cells of the pancreas. It is usually increased before meals and concentrations fall after a meal. Ghrelin promotes food intake. It achieves this by acting on the hypothalamus in the brain and stimulating hunger in an individual. It also inhibits the feeling of satiety by blocking sensory stimulus to the brain from the stomach generated due to stretching of its walls after food intake. It also activates a feedback mechanism from the brain that reinforces reward (good feeling) after food intake. It promotes deposition of fat tissue around the abdomen. Ghrelin also has a role in cognitive learning and helps individuals adapt to different environments efficiently. It also stimulates release of growth hormone. It has a counter hormone i.e. leptin which is produced in the fat tissues. Leptin induces satiety and a sensation of fullness.

Stomach

The stomach is a muscular sac that lies between the esophagus and the small intestine in the upper abdomen. The stomach is not the only part of your digestive system that absorbs food but rather is a part of the digestive system and important for churning food into a consistency that is easier to digest for the rest of your intestines.

Why do you leave part of the stomach behind during a gastric bypass?

During a gastric bypass, the lower (distal) larger part of the stomach is left in place because of the stomach still produces acid and pepsin to help digestion of the food. These digestive juices travel down the duodenum and into the jejunum to mix with food. Removing the lower part of the stomach raises the possibility of complications without proven benefit

In rare cases, if for any reason a patient needs to have the operation reversed, the stomach is still there and can be hooked up again. This remnant stomach can also be used to help feeding if an unrelated serious medical problem should

Revisional Bariatric Surgery

Current thinking is that revisional operations do not work very well and for that reason they are reserved for unique cases. As with many things in surgery, much depends on the circumstances and the available options, some of which we’ll describe below. In any case, I strongly suggest that patients return to their original surgeon who performed their first operation, as every surgeon individualizes the digestive arrangements in a particular manner. The only revisional operation I regularly perform is for patients who have a failed laparoscopic gastric banding. Those patients may benefit from having the band removed and then converting to a gastric bypass or a gastric sleeve.

How to Measure your Waist to Hip Ratio

The waist-to-hip ratio (WHR) is the ratio of the circumference of the waist to that of the hip. The proportion of fat stored in the abdominal area to that stored in the hip region is an important indicator of the risk for a number of conditions. These conditions include major health risks such as diabetes, hypertension, and heart disease. A high WHR increases the chances of acquiring these conditions.

Theoretic Hormonal Impact of Laparoscopic Sleeve Gastrectomy Surgery

Classified as a restrictive procedure, laparoscopic sleeve gastrectomy involves modification of the gastric fundus, which expresses various hormones associated with hunger and satiety, insulin secretion and energy balance, and is known to induce rates of type 2 diabetes remission comparable to those observed following malabsorbtive procedures such as the Roux-en-Y gastric bypass (RYGB).

Sleeve

Laparoscopic sleeve gastrectomy is a restrictive procedure that reduces the size of the stomach but does not alter the gastrointestinal tract or the pylorus. Because the route of ingested food through the gastrointestinal tract is not altered, nutrients are better absorbed. The patient is less dependent on vitamin supplements as the food is absorbed in a more natural manner.

Theoretical Gut Hormone Changes after Gastric Bypass

Roux-en-Y gastric bypass (RYGB) surgery is one of the most commonly performed bariatric procedures, offering significant long-term benefits in terms of weight reduction and remission of obesity-related conditions including type 2 diabetes. These changes are thought to be induced via a combination of mechanisms including reduction in stomach capacity and reduced absorption of fat, in addition to the restrictions placed on consumption of highly osmolar foods such as those high in simple sugars, which can trigger symptoms including nausea, vomiting and dizziness if ingested in excessive quantities. However, these factors alone do not fully account for the success of the procedure. Various hormonal changes have been observed following RYGB surgery, prior to significant weight loss, and it is thought that such endocrine effects could also contribute towards the mechanism of action in RYGB.

Weight Loss

Bariatric surgery requires a change in the way that you think about food, dieting and exercise. Although there are definite physiological changes that occur after surgery and that will help you lose weight, it is important that you realize the need to change your environment and some of your previous lifestyle choices. Although the operations change the way in which your body processes food, some of these changes are only temporary. It is important that you start life-affirming habits that will help you succeed.

Starting Fresh with Bariatric Nutrition

Significant weight loss can sometimes cure and almost always decrease the risks of developing secondary conditions related to obesity which include, hypertension, diabetes, heart disease and the pressure and pains that accompany supporting excess weight. As a result of weight loss and positive lifestyle changes, you can be better prepared to engage in the physical activities of daily living, improve your mobility and appearance, and extend your years of healthy living with your family and loved ones.