Cook Tyler M, Bethea Maigen M, Sandoval Darleen A
Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Denver, CO, USA.
Curr Opin Neurobiol. 2025 Jun;92:103041. doi: 10.1016/j.conb.2025.103041. Epub 2025 May 10.
Bariatric surgery is the gold standard for sustained weight loss. Despite common misconceptions, bariatric surgery remodels gut-brain physiology in more complex ways than simply reducing stomach size or causing nutrient malabsorption. Bariatric surgery induces weight loss primarily by reductions in food intake and alterations in feeding patterns, macronutrient preference, and the rewarding aspects of food. Bariatric surgery also enhances nutrient-induced brain activation, alters nutrient processing, enhances gut hormone secretion, and increases bile acids. However, which of these signals directly link to improved satiety and altered reward pathways remains unclear. While state-of-the-art tools are now available to manipulate specific subpopulations of peripheral sensory neurons, work is needed to apply these tools to obesity and bariatric surgery. This will be critical for advancing the understanding of the role of the gut-brain axis in the success of surgery and allowing for the continued expansion of therapeutic options for obesity.
减肥手术是实现持续体重减轻的金标准。尽管存在常见误解，但减肥手术以比单纯缩小胃尺寸或导致营养吸收不良更为复杂的方式重塑肠-脑生理。减肥手术主要通过减少食物摄入量以及改变进食模式、宏量营养素偏好和食物的奖赏特性来实现体重减轻。减肥手术还会增强营养素诱导的大脑激活、改变营养素处理过程、增强肠道激素分泌并增加胆汁酸。然而，这些信号中哪些直接与饱腹感改善和奖赏途径改变相关仍不清楚。虽然现在已有先进工具可用于操纵外周感觉神经元的特定亚群，但仍需开展工作将这些工具应用于肥胖症和减肥手术。这对于推进对肠-脑轴在手术成功中所起作用的理解以及使肥胖症治疗选择得以持续扩展至关重要。
