Do Hormones Play A Role in Weight Loss Failure After Bariatric Surgery?

Obesity surgery is currently the most effective treatment available for severe obesity.  While the smaller stomach reservoirs that are created by these surgeries play a major role in the weight loss seen, it is becoming increasingly evident that there are many other contributors at work, one of which is thought to be alterations in various hormone levels after surgery.

I was asked to write a review article discussing what we know about hormone changes in relation to weight loss failure and weight regain after bariatric surgery, which was recently published in the journal Gastroenterology Research and Practice.  In the article, I review eight of the key hormones thought to be involved in the weight changes after bariatric surgery (from GLP-1 to PYY to oxyntomodulin, bile acids, and others), as well as what we know about the hormone changes that occur after the four main types of bariatric surgery (gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion).

In summarizing what we know about hormonal associations with weight loss failure and weight regain after bariatric surgery, there was painfully little to discuss - there is unfortunately very little data in this area.

What became poignantly clear to me from compiling this review is that more research is desperately needed to help us understand how hormones may contribute to weight loss failure or regain after obesity surgery.  As I noted in the article,

In the future, with a better understanding

of this complex arena, assessment of hormone status

could potentially be helpful in understanding the hormonal

contributors to a patient’s postoperative weight loss failure

or recidivism, potentially aiding the clinician in utilizing

appropriate targeted hormone therapy to help them achieve

successful or sustained weight loss.

This is probably not a wish I should expect to see fulfilled anytime soon - after all, pinpointing hormonal predictors of weight regain after 'regular' dietary-induced weight loss has proven evasive as well.  However, with a dedicated body of bariatric researchers worldwide, I hope that we will learn more about this important area with time. 

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