Mucosal and hormonal adaptations after Roux-en-Y gastric bypass

Fauzi Feris, Alison McRae, Todd A. Kellogg, Travis McKenzie, Omar Ghanem, Andres Acosta

Research output: Contribution to journalReview articlepeer-review


The aim of this study was to perform a comprehensive literature review regarding the relevant hormonal and histologic changes observed after Roux-en-Y gastric bypass (RYGB). We aimed to describe the relevant hormonal (glucagon-like peptides 1 and 2 [GLP-1 and GLP-2], peptide YY [PYY], oxyntomodulin [OXM], bile acids [BA], cholecystokinin [CCK], ghrelin, glucagon, gastric inhibitory polypeptide [GIP], and amylin) profiles, as well as the histologic (mucosal cellular) adaptations happening after patients undergo RYGB. Our review compiles the current evidence and furthers the understanding of the rationale behind the food intake regulatory adaptations occurring after RYGB surgery. We identify gaps in the literature where the potential for future investigations and therapeutics may lie. We performed a comprehensive database search without language restrictions looking for RYGB bariatric surgery outcomes in patients with pre- and postoperative blood work hormonal profiling and/or gut mucosal biopsies. We gathered the relevant study results and describe them in this review. Where human findings were lacking, we included animal model studies. The amalgamation of physiologic, metabolic, and cellular adaptations following RYGB is yet to be fully characterized. This constitutes a fundamental aspiration for enhancing and individualizing obesity therapy.

Original languageEnglish (US)
Pages (from-to)37-49
Number of pages13
JournalSurgery for Obesity and Related Diseases
Issue number1
StatePublished - Jan 2023


  • Bariatric surgery
  • Gastric bypass
  • Gut hormones
  • Metabolic adaptations
  • Mucosal adaptations
  • Obesity
  • Roux-en-Y gastric bypass
  • Satiety hormones

ASJC Scopus subject areas

  • Surgery


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