Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Obes Rev. 2011 Nov;12(11):935-51. doi: 10.1111/j.1467-789X.2011.00901.x. Epub 2011 Jul 6.
The gastrointestinal tract plays an important role in the improved appetite control and weight loss in response to bariatric surgery. Other strategies which similarly alter gastrointestinal responses to food intake could contribute to successful weight management. The aim of this review is to discuss the effects of surgical, pharmacological and behavioural weight loss interventions on gastrointestinal targets of appetite control, including gastric emptying. Gastrointestinal peptides are also discussed because of their integrative relationship in appetite control. This review shows that different strategies exert diverse effects and there is no consensus on the optimal strategy for manipulating gastric emptying to improve appetite control. Emerging evidence from surgical procedures (e.g. sleeve gastrectomy and Roux-en-Y gastric bypass) suggests a faster emptying rate and earlier delivery of nutrients to the distal small intestine may improve appetite control. Energy restriction slows gastric emptying, while the effect of exercise-induced weight loss on gastric emptying remains to be established. The limited evidence suggests that chronic exercise is associated with faster gastric emptying, which we hypothesize will impact on appetite control and energy balance. Understanding how behavioural weight loss interventions (e.g. diet and exercise) alter gastrointestinal targets of appetite control may be important to improve their success in weight management.
胃肠道在肥胖症手术引起的食欲控制和体重减轻中起着重要作用。其他类似改变胃肠道对食物摄入反应的策略也可能有助于成功的体重管理。本综述的目的是讨论手术、药理学和行为减肥干预对食欲控制的胃肠道靶点的影响，包括胃排空。还讨论了胃肠肽，因为它们在食欲控制中具有综合关系。本综述表明，不同的策略产生不同的效果，对于操纵胃排空以改善食欲控制的最佳策略尚无共识。来自手术程序（例如胃袖状切除术和 Roux-en-Y 胃旁路术）的新证据表明，更快的排空速度和更早地将营养物质输送到远端小肠可能会改善食欲控制。能量限制会减缓胃排空，而运动引起的体重减轻对胃排空的影响仍有待确定。有限的证据表明，慢性运动与更快的胃排空有关，我们假设这将影响食欲控制和能量平衡。了解行为减肥干预（例如饮食和运动）如何改变食欲控制的胃肠道靶点对于提高它们在体重管理中的成功率可能很重要。
