Ali Tavakkoli, M.D.

The biology of weight loss surgery

Weight loss operations have become the gold standard therapy in our fight against the worsening obesity and type 2 diabetes (T2D) epidemics.  An impressive observation has been the rapid resolution of T2D within days of surgery and before any substantial weight loss specifically following the Roux-en-Y Gastric Bypass surgery (RYGB). Although many national and international diabetic societies have incorporated these procedures in their treatment algorithm of obese diabetics, unfortunately 70% of diabetic patients do not qualify for weight loss surgery based on the current surgical guidelines. We have been intrigued by the observation that RYGB leads to a rapid and weight independent resolution of T2D, and to help us better understand the mechanism involved, have focused our studies on the changes in intestinal nutrient absorption and sensing that occurs after this intervention.  Our goal is to develop less invasive procedures that can replicate the metabolic benefits of RYGB.

References:

1. Stearns AT, Balakrishnan A, Rounds J, Rhoads DB, Ashley SW, Tavakkolizadeh A. Capsaicin-sensitive vagal afferents modulate post-transcriptional regulation of the rat sodium-glucose cotransporter. Am J Physiol. 2008;294:G1078-83.

 

2. Stearns AT, Balakrishnan A, Tavakkolizadeh A. Impact of Roux-en-Y gastric bypass surgery on rat intestinal glucose transport. Am J Physiol. 2009;297:G950-G957. PMCID:PMC2777457

 

3. Balakrishnan A, Tavakkolizadeh A, Rhoads DB. Circadian clock genes and implications for intestinal nutrient uptake. Nutr Biochem. 2012 May;23(5):417-22. PMCID:PMC3331921

 

4. Bhutta H, Deelman T, Ashley SW, Rhoads DB, Tavakkoli A. Disrupted diurnal rhythmicity of the intestinal glucose transporter SGLT1 in Zucker Diabetic Fatty rats: a model of obesity-induced diabetes. Dig Dis Sci. 2013;58(6):1537-45. PMCID:PMC3691300



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