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Int J Obes (Lond). 2011 Mar;35(3):457-61. doi: 10.1038/ijo.2010.168. Epub 2010 Aug 24.

Bariatric surgery in a patient with complete MC4R deficiency.

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  • 1Division of Endocrinology, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.


Bariatric surgery is often successful for treatment of severe obesity. The mechanisms of weight loss after bariatric surgery and the role of central energy homeostatic pathways in this weight loss process are not well understood. The study of individuals with complete loss of function of genes important in the leptin-melanocortin system may help establish the significance of these pathways for weight loss after bariatric surgery. We describe the outcome of bariatric surgery in an adolescent with compound heterozygosity and complete functional loss of both alleles of the melanocortin 4 receptor (MC4R). The patient underwent laparoscopic adjustable gastric banding and truncal vagotomy at years of age, which resulted in initial, but not long-term weight loss. Our experience with this patient suggests that complete MC4R deficiency impairs response to gastric banding and results in poor weight loss after this surgery.

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