While weight-loss surgery has proven to be an effective long-term health treatment, it can also be expensive, can come with a host of unpleasant side effects, is invasive, and around a third of recipients will require follow-up surgery or hospitalization within five years. It’s no surprise, then, that only about 1% of those who have qualifying weight concerns actually go through with it.
A new study has highlighted the metabolic benefits of weight loss surgery, in particular its impact on bile acid levels and the role this plays in appetite regulation. The researchers found that those who had undergone weight loss surgery had much lower levels of the bile acid isoursodeoxycholate (isoUDCA), which is linked to higher appetite and worse metabolic levels.
Studying the bile acid levels of a group of post-surgery patients in Amsterdam, as well as two other non-surgery general populations, the researchers found that a fiber supplement naturally lowered isoUDCA levels. This opens the door to developing a treatment that could mimic the appetite reduction and better metabolic function to help people lose weight without any invasive procedures.
“By better understanding the complex interplay between genetics, the gut microbiome, and diet in regulating bile acid levels and their impact on appetite and metabolic health, we may be able to develop new strategies for preventing and treating obesity and metabolic syndrome,” said joint lead author Cristina Menni from King’s College London.
It’s not the first time scientists have turned to the gut microbiome for weight-loss answers, but the researchers from the University of Nottingham, King’s College London and Amsterdam University Medical Center have shed new light on a poorly understood benefit of bariatric surgery – the reduced appetite.
Understanding the metabolic mechanisms that result in a lower appetite could lead to a safe and effective treatment for weight loss. Obesity is associated with serious conditions including diabetes and heart disease, with many able to be reduced or even reversed with weight loss.
“What our study shows is that specific microbial metabolite is involved in some of these benefits and that, although to a more modest extent, dietary fiber might mimic some of these effects,” said joint lead author Ana Valdes, from the University of Nottingham’s School of Medicine. "This could help design dietary supplementation studies aimed at increasing satiety and improving liver parameters.”
The research underlines how big a role our gut microbes have in influencing metabolism and in regulating levels of isoUDCA.
“This study highlights the key role that fiber plays in appetite regulation and metabolism, harnessed by specific gut microbes,” said co-author Tim Spector, Professor of Genetic Epidemiology at King’s College London. “The gut microbiome and its chemical products such as these bile acids hold huge promise for reducing obesity without the need for invasive surgery.”
The research was published in the journal Cell Reports Medicine.
Source: University of Nottingham
