Physiologic Mechanisms of Weight Loss Following Metabolic/Bariatric Surgery

mechanisms similarly was guided by anatomic understandings alone. Bariatric operations initially were viewed as restrictive, malabsorptive, or a combination of both. As the strong antidiabetic effects of surgery have been documented in multiple randomized studies, it has become clear that underlying mechanisms of surgery are more complex. This complex biology has yet to be elucidate fully, although significant progress has been made. No single theory has emerged as the dominate unifying mechanism. It is plausible, if not likely, that multiple mechanisms are responsible for postoperative weight and metabolic changes, with some degree of overlap. A key clinical observation with respect to postbariatric metabolic improvements has