Introduction: Gut and adipose tissue hormones play an important role in energy balance control, particularly through the regulation at either short- or long-term food intake after bariatric surgery. Case: A 15-year-old obese female (BMI 42.2) who was unresponsive to medical treatment underwent gastroplication. Hunger hormone levels (leptin, ghrelin and insulin), weight loss and eating behavior were monitored at 3, 6 and 12 months after surgery. Results: Weight loss was obtained, progressively achieving a loss of 45.6 kg 1 year after surgery. A strong reduction in insulin concentration and insulin resistance was documented. At 3 months after the operation, a surprising leptin level drop was observed. During the following months a progressive increase in leptin levels and leptin/kg of fat mass were documented. Fasting ghrelin levels increased in the first 3 months, then fell over the next 6 months. Up to 6 months after gastroplication, we observed a less marked drop in plasma ghrelin after meal ingestion, while the values after 1 year showed a substantial fall in the postprandial period despite a further fasting ghrelin increased level. Early achievement of satiety was found. Conclusion: Hunger hormones level changes seem to be involved in weight loss and eating behavior after gastroplication in adolescents.

World Health Organization (WHO): Obesity. Geneva, WHO, 2008.
Suter M, Giusti V: Bariatric surgery in 2013: principles, advantages and disadvantages of the available procedures (in French). Rev Med Suisse 2013;9:660-663.
Ochner CN, Gibson C, Shanik M, Goel V, Geliebter A: Changes in neurohormonal gut peptides following bariatric surgery. Int J Obes (Lond) 2011;35:153-166.
Pournaras DJ, Le Roux CW: The effect of bariatric surgery on gut hormones that alter appetite. Diabetes Metab 2009;35:508-512.
Pimentel GD, Micheletti TO, Pace F, Rosa JC, Santos RV, Lira FS: Gut-central nervous system axis is a target for nutritional therapies. Nutr J 2012;11:22.
Calcaterra V, Cena H, Nakib G, Fonte M, Vandoni M, Valenti A, Biancotti V, Pelizzo G: Robotic-assisted gastroplication in a morbidly obese adolescent: early improvement in metabolic and neurohormonal parameters. Pediatr Rep 2012;4:e36.
Cuzzolaro M, Vetrone G, Marano G, Battacchi MW: BUT, Body Uneasiness Test: a new attitudinal body image scale. Psichiatria dell'infanzia e dell'adolescenza 1999;66:417-428.
Schweitzer DH, Dubois EF, van den Doel-Tanis N, Oei HI: Successful weight loss surgery improves eating control and energy metabolism: a review of the evidence. Obes Surg 2007;17:533-539.
Perry B, Wang Y: Appetite regulation and weight control: the role of gut hormones. Nutr Diabetes 2012;2:e26.
Suzuki K, Jayasena CN, Bloom SR: Obesity and appetite control. Exp Diabetes Res 2012;2012:824305.
Yu JH, Kim MS: Molecular mechanisms of appetite regulation. Diabetes Metab J 2012;36:391-398.
Michalakis K, le Roux C: Gut hormones and leptin: impact on energy control and changes after bariatric surgery-what the future holds. Obes Surg 2012;22:1648-1657.
Hage MP, Safadi B, Salti I, Nasrallah M: Role of gut-related peptides and other hormones in the amelioration of type 2 diabetes after Roux-en-Y gastric bypass surgery. ISRN Endocrinol 2012;2012:504756.
Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ: Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002;346:1623-1630.
Ionut V, Bergman RN: Mechanisms responsible for excess weight loss after bariatric surgery. J Diabetes Sci Technol 2011;5:1263-1282.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.