Surgery>>>>>The Surgical Management of Obesity
Question 8#

In addition to the effects of weight loss, the resolution of type 2 diabetes mellitus after the gastric sleeve procedure and RYGB is thought to be contributed to by:

a. Reduced ghrelin production
b. Increased secretion of glucagon -like peptide-1 ( GLP-1)
c. Appetite suppression
d. All of the above

Correct Answer is D


Gastrectomy removes much of the ghrelin-producing portion of the stomach, and is thought to contribute to weight loss after both gastric sleeve and RYGB procedures. GLP-1, the enteric hormone which augments insulin release, is dramatically increased after RYGB, and is increased after gastric sleeve as well. A profound suppression of appetite and food craving has been found to follow these procedures, presumably due to the altered hormonal status of peptides which affect the satiety centers of the central nervous system.