Hormonal
Bariatric surgery (RYGB or SG) improves peripheral insulin sensitivity only after substantial weight loss (>30%) is achieved at 1 year, whereas low-calorie diet (LCD) fails to improve insulin sensitivity despite initial weight loss, indicating that the magnitude of weight loss, not the surgical mechanism itself, drives late-stage insulin sensitivity improvements.
If you undergo bariatric surgery, do not expect immediate improvements in insulin sensitivity. The metabolic benefits, such as improved insulin sensitivity, typically take about a year to manifest and are directly tied to the amount of weight you lose. If you do not lose significant weight, your insulin sensitivity may not improve, regardless of the surgery type.
One year after surgery, insulin sensitivity at both 20 and 80 mU/m2/min insulin infusion doses increased with BS weight loss (−33.8% ± 1.4% body weight) but was unchanged in LCD with small weight loss (−3.7% ± 2.0% body weight)... Most improvements in cardiometabolic health were related to weight loss.
Why this rating
Prospective observational study with gold-standard hyperinsulinemic-euglycemic clamp measurements, but small sample size (n=19) and self-selection bias limit generalizability.
Source
Changes in insulin sensitivity and gut peptides 8 and 52 weeks after bariatric surgery or low‐calorie diet
Adam C. Lowe et al. · Clinical Obesity · 2024
DOI 10.1111/cob.12726
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