Hormonal
Roux-en-Y gastric bypass (RYGB) induces a progressive, adaptive rise in postprandial satiety hormones (PYY, GLP-1, enteroglucagon) and suppresses the compensatory rise in ghrelin, which explains the sustained weight loss and altered satiety without the typical counter-regulatory increase in appetite.
For individuals with morbid obesity, standard diet and exercise often fail long-term because the body increases hunger hormones (like ghrelin) to defend its higher weight. Roux-en-Y gastric bypass physically alters the gut to produce more satiety hormones (PYY, GLP-1) and suppresses hunger signals. This hormonal shift explains why patients feel fuller faster and stay full longer, leading to sustained weight loss without the typical rebound hunger seen in dieting. It is a physiological reset, not just a restriction.
Lack of the expected increase in appetite and food intake as components of a counter-regulatory response may be explained by gut adaptation and the consequent graded rise in the levels of gut hormones that promote satiety.
Why this rating
Small sample size (n=6), prospective design, but robust hormonal measurements and clear statistical significance for hormone changes.
Source
Progressive rise in gut hormone levels after Roux-en-Y gastric bypass suggests gut adaptation and explains altered satiety
Cynthia-Michelle Borg et al. · British journal of surgery · 2006
DOI 10.1002/bjs.5227
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