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Trends Endocrinol Metab. 2018 Apr;29(4):218-237. doi: 10.1016/j.tem.2018.01.009. Epub 2018 Feb 20.

Brain Feeding Circuits after Roux-en-Y Gastric Bypass.

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Department of Experimental Surgery, University Hospital Wuerzburg, Wuerzburg, Bavaria 97080, Germany; German Research Foundation Collaborative Research Center in Obesity Mechanisms, University of Leipzig, Leipzig, Saxony 04103, Germany. Electronic address:
Department of Experimental Surgery, University Hospital Wuerzburg, Wuerzburg, Bavaria 97080, Germany.
Department of Investigative Science, Imperial College London Academic Healthcare Centre, London W12 0NN, UK.
Metabolic Disease and Obesity Program, Biomedicine Discovery Institute, Monash University, Victoria 3800, Australia; Department of Physiology, Monash University, Victoria 3800, Australia.


Metabolic surgical procedures, such as Roux-en-Y gastric bypass (RYGB), uniquely reprogram feeding behavior and body weight in obese subjects. Clinical neuroimaging and animal studies are only now beginning to shed light on some of the underlying central mechanisms. We present here the roles of key brain neurotransmitter/neuromodulator systems in food choice, value, and intake at various stages after RYGB. In doing so, we elaborate on how known signals emanating from the reorganized gut, including peptide hormones and microbiota products, impinge on newly mapped homeostatic and hedonic brain feeding circuits. Continued progress in the rapidly evolving field of metabolic surgery will inform the design of more effective weight-loss compounds.


Roux-en-Y gastric bypass; brain feeding circuits; feeding behavior; functional magnetic resonance imaging; gastrointestinal tract; positron emission tomography

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