Grant: Team Grant: Bariatric Care - Mechanisms underlying bariatric procedures

For most severely obese patients, bariatric surgery is more effective than medical treatment or lifestyle modification to induce long-term weight loss with durable remission of metabolic diseases. Various types of surgical operations are available. These surgeries promote weight loss through two general mechanisms according to the type of surgery: 1) restrictive surgeries limit the amount of food consumed by reducing the size of the stomach; 2) malabsorptive surgeries limit the absorption of nutrients by reorganizing or bypassing portions of the small intestine. Better knowledge on each of the procedures will help in identifying the right surgery for the right patient. We hereby propose to investigate the determinants of metabolic recovery after restrictive or malabsorptive/restrictive surgical procedures in humans and relevant rodent models. The proposed research team involves investigators across Canada in 3 provinces and 8 universities as well as collaborators from the US and Europe. In sum, we have an increasing body of knowledge on the clinical effects of each surgical paradigm, but we do not yet have a clear understanding of the mechanisms that contribute to sustained weight loss and long-term metabolic recovery following surgery. The selection of a specific surgical approach in a given clinical context is faced with many unanswered questions that call for a better understanding of these mechanisms.