Format

Send to

Choose Destination
J Clin Res Pediatr Endocrinol. 2016 Jun 5;8(2):250-6. doi: 10.4274/jcrpe.2283. Epub 2015 Dec 18.

Long-term Outcome after Robotic-assisted Gastroplication in Adolescents: Hunger Hormone and Food Preference Changes Two Case Reports.

Author information

1
Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Maternal and Children's Health, Pediatric Surgery Unit, Pavia, Italy, Phone: +39 038 250 29 30 E-mail: g.pelizzo@smatteo.pv.it.

Abstract

Weight loss surgery (WLS) is efficacious for long-term weight reduction and decreases overall mortality in severely obese patients. The mechanisms implicated in long-term weight loss are not fully understood. Proposed mechanisms include changes in gut hormones and brain regulation of appetite and satiety. We aimed to investigate the long-term ghrelin and leptin profiles and changes in food preference and eating behavior after WLS in adolescent patients. Two obese females aged 15 years and 14 4/12 years, who did not respond to lifestyle changes, including dietary intervention and physical exercise in combination with medical therapy, underwent robotic-assisted gastroplication. Anthropometric measurements, food habits and eating behavior, as well as metabolic and hormonal changes during long-term post-surgical follow-up were monitored. Long-term weight reduction was obtained in both patients, with a significant decrease in waist circumference. Resting energy expenditure showed a decrease over time, with a respiratory quotient that increased showing a shift from oxidation of a high-fat diet before surgery to oxidation of a mixed diet two and three years later. Both subjects improved their eating habits and lifestyle. Co-morbidity resolution was also noted. Increased pre-prandial ghrelin levels as well as higher post-prandial ghrelin and a leptin drop compared with pre-surgery values were observed in both patients. Persistent weight loss after gastroplication is associated with a favorable change in gut hormones and food preferences. The role of hormonal and sensory components in long-term results seems crucial. Particularly in adolescent patients, a multidisciplinary approach and continuous nutritional care is mandatory for weight maintenance and consolidation of changes.

PMID:
26757831
PMCID:
PMC5096486
DOI:
10.4274/jcrpe.2283
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Galenos Yayinevi Icon for PubMed Central
Loading ...
Support Center