Mixed
Vertical sleeve gastrectomy (VSG) induces durable metabolic benefits and weight loss in nonhuman primates that are independent of caloric intake, mediated by early increases in bile acids and short-chain fatty acids, reduced visceral adipose tissue inflammation, and a polarization of immune cells toward regulatory phenotypes.
Vertical sleeve gastrectomy (VSG) is a highly effective intervention for obesity that works through complex biological mechanisms beyond simple stomach size reduction. It triggers early increases in beneficial metabolites (bile acids, short-chain fatty acids) and shifts the immune system in fat tissue to reduce inflammation and improve insulin sensitivity. These changes occur even if caloric intake remains the same, indicating that VSG fundamentally alters how the body regulates energy and metabolism. For patients, this means VSG offers durable metabolic benefits, including improved glucose control and reduced visceral fat inflammation, which are critical for long-term health independent of weight loss alone.
We also show that VSG confers weight loss and durable metabolic benefit, where equivalent caloric intake in shams resulted in significant weight gain following surgery. Furthermore, we show that VSG is associated with early, weight-independent increases in bile acids, short-chain fatty acids, and reduced visceral adipose tissue (VAT) inflammation with a polarization of VAT-resident immunocytes toward highly regulatory myeloid cells and Tregs.
Why this rating
High-quality nonhuman primate model with controlled variables, sham controls, and longitudinal data, though not a human RCT.
Source
A nonhuman primate model of vertical sleeve gastrectomy facilitates mechanistic and translational research in human obesity
Julia L. Nugent et al. · iScience · 2021
DOI 10.1016/j.isci.2021.103421
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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