Metabolic Surgery

acute effects of leptin on synaptic plasticity in the arcuate nucleus of the hypothalamus. The arcuate nucleus is one of the key targets of circulating hormones such as leptin. At least two distinct populations of neurons with opposing actions on food intake residein the arcuate nucleus, " (p.63). Pinto's data is ultimately described as helpful but also created many more questions, probably more than it answered.

Modern scientific research has also linked the hormone leptin to appetite and feeding behavours. Leptin is a hormone (produced by the fat cells) that naturally suppresses the appetite. In general, the more fat you have, the more leptin you produce. When working efficiently, Leptin signals to the brain to indicate if energy stores (such as fat) are adequate or inadequate. It does so in the arcuate nucleus by inhibiting stimulatory neurons by stimulating inhibitory fibers. It appears it is possible however for the arcuate nucleus to become

Bariatric Surgery is surgery on the stomach of a person to help with serious signs of obesity. With this surgery there are many type of procedures that all causes you to loss weight but there are man type of ways to do so. Bariatric surgery also known as a type of weight loss surgery it is optional for people who have a bmi also known as body mass index only if greater than 40 you are considered obese. Your BMI is based on your height and weight. It's one way to see if you're at a normal healthy weight for yourself. Your BMI for being Underweight is less than 18.5. Your BMI at an Healthy weight is 18.5 to 24.9.Your BMI for overweight is 25 to 29.9. Finally Your BMI for obesity would be 30 or higher. Surgery is also an option for human beings with a body mass index between 35 and 40 who have health problems like type 2 diabetes or heart disease.There are two main types of bariatric surgery which are restrictive surgeries and malabsorptive surgeries.

The surging adult obesity rate has contributed to the booming demand for bariatric (weight loss) surgeries around the world. People in need of significant body mass reduction are now increasingly opting for weight loss surgery procedures to tackle their weight issues.

This system is comprised of Pro-opiomelanocortin (POMC) and AgRP neurons of the arcuate hypothalamus (Arc), neuropeptides α-MSH and AgRP, and central melanocortin receptors (MCRs) MC3R and MC4R. POMC and AgRP neurons monitor energy state and change their activity to alter feeding and body weight. When energy needs are met, POMC neurons release α-MSH which acts as an agonist on MC3R and MC4R. AgRP is released in response to an energy deficit and acts as an inverse agonist/antagonist of the central MCRs. Activation of POMC and AgRP neuron signaling has an opposite effect on feeding behavior such that the stimulation of POMC neurons or injection of MCR agonist decreases food intake and body weight27-29 , whereas AgRP neuron activation, central administration or overexpression of AgRP stimulates food intake and weight gain27,30-33. In addition to neuropeptide-mediated signaling, both POMC and AgRP neurons are also capable of fast neurotransmission via Glutamate and/or GABA34-36 and this neurotransmission has been suggested to play an important role in the ability of POMC and AgRP neurons to control feeding27,32. Although much is known about the role of AgRP and POMC neurons in the regulation of feeding and body weight, there is still much to be learned about the larger role these neurons play in energy homeostasis, including their interactions with non-homeostatic circuits, and a better understanding of the role GABA and Glutamate released from POMC and AgRP neurons play in feeding

In accordance with the previous findings, one particular trial (Cohen et al., 2012) specifically examined the long term effect of Roux-en-Y gastric bypass surgery on patients with T2DM with Class I obesity (BMI between 30-35 kg/m2). The study followed 66 patients who underwent this procedure for a period of six years and found that 88% of the participants were able to achieve euglycemia without the use of standard diabetic therapy and 11 % had an improvement in glycemic control in comparison to standard therapy (Cohen et al., 2012). Interestingly, the study (Cohen et al., 2012) points out that there was an improvement in Beta cell function in the pancrease due to an increase in C-peptide response to glucose after the procedure.

In the gastric sleeve surgery, the stomach is reduced to the “size of a banana” creating a thin vertical sleeve (Weight Loss Surgery Health Center: Gastric Sleeve Surgery, 2011). The stomach is removed during this surgery so it is not reversible. During the Roux-en-Y (RYGB) surgery, the stomach is made smaller and made into a new pouch that is roughly the size of an egg then connected to the middle portion of the small intestine. This type of surgery leads to less absorption of calories in the small intestine (Weight Loss Sugery Health Center: Roux-En-Y Gastric Bypass, 2011). In this method the surgery can be reversed for many reasons, typically due to

Bariatric surgery approach is performed after other medical treatments for loosing weight have been tried with no success (Nix, 2017). Bariatric surgeries include the adjustable gastric band, gastric bypass, sleeve gastrectomy, biliopancreatic diversion with duodenal switch. The overall concept of these surgeries is to make the stomach smaller or induce malabsorption. If the stomach is smaller, less amount of food is being consumed and with malabsorption, most nutrients are not being absorbed (American Society for Metabolic and Bariatric Surgery, 2018).

The bypass surgery is the most common and has the most significant amount of weight loss (Groven et al 509). The bypass procedure divides the patients stomach into two pieces, and reroutes the intestine to the smaller of the two pouches (Groven et al 509). This limits the amount of food a patient can eat as well as reducing food absorption after indigestion. Whereas the sleeve gastrectomy, a newer weight loss surgery procedure, by removing a portion of your stomach—resulting in the absorption of a limited number of calories. All the weight loss surgical procedures reduce caloric intake by modifying the anatomy of the gastrointestinal tract; therefore, resulting in not only weight loss but the loss or reduction of existing comorbidities

As most patients should know, a bariatric surgery is a procedure conducted by a bariatric surgeon or medical licensed professional. The primary factor of a bariatric surgery is to aid in weight reduction; therefore, this surgery is mainly issued to patients who are morbidly obese. This type of surgery can also be reserved for patients that are not responding well to their diet or have been decreasing in their physical activities. It should be well noted that there are four types of bariatric surgeries, each of them serving a different purpose for the needs of the patient.

Sleeve gastrectomy is a weight loss procedure where the stomach is made smaller by surgical removal to form a slim “sleeve.” Patients can eat only small amounts of food, resulting in weight loss. A sleeve gastrectomy is often followed by duodenal switch surgery or a gastric bypass.

According to Dr. Hatzifotis (Surgery Brisbane, 2017) the gastric sleeve is the most common procedure of bariatric surgery around the world. This procedure involves a surgery where the surgeon permanently removes about seventy percent of the stomach. By this, the surgeon will leave a narrow stomach tube instead of a stomach sack and due to this the stomach is reduced from 1.5 litres of food and liquid to two hundred millilitres (mls).

Therefore venting stress is good for a person's health. If a person is obese, they can lose the weight by exercising or bariatric surgery. There are four different types of bariatric surgery that are most common. They are biliopancreatic diversion with duodenal switch (BPD/DS) gastric bypass, adjustable gastric band, sleeve gastrectomy, and gastric bypass.

A rise in the number of gastrointestinal surgeries being performed for weight loss is a reflection of the increase in the number of people who are morbidly obese. According to Steinbrook (2004), “gastrointestinal surgeries performed annually for severe obesity increased from 16,000 in the early 1990s to about 103,000 in 2003” (p. 1075). Bariatric surgery, like all major surgery, carries inherent risks, but due to the nature of the patients seeking these procedures standard risks can be compounded. Additionally, each unique bariatric procedure has different benefits and dangers.

While diet therapy has been utilized to help in reducing weight, statistics shows that over 90 percent of individuals who lose weight in this manner gain it back(SITE). As a result, other initiatives such as bariatric surgery were derived. Candidates for bariatric surgery are either severly obese with co-mobordities or morbidly obese(SITE). Severe obesity is defined as having a BMI of 35 to 39 and morbid obesity is having a BMI of 40 or more (SITE). BMI is usually derived from the amount one weighs and their height (SITE).. It is associated with the risk of diseases such as type 2 diabetes, cardiovascular disease, pulmonary disease, osteoarthritis, certain cancers and overall quality of life (SITE).