The Wild World of Ghrelin

One thing I have been appreciative of is the education provided by the bariatric department at North Valley Surgical Associates. I originally started my surgery process with another surgical center -- oh wait, make that two prior surgical centers. I had not received the type of education I've received with NVSA. The doctors and nurses introduced a new concept to me. You may agree or disagree with their theories, you have to make the call yourself. As a person who has multiple failed attempts at weight loss, I tend to agree.

We all know that our society has a love-hate relationship with food and weight. They place the fresh bakery at the front of the grocery store to draw you in. They've put fast food and high calories coffee shops on every corner in this country. How many calories in a medium sized white chocolate mocha? 470. Do I need 470 calories at 6:10am? Probably not, but it sure tastes good. ;-) We're bombarded with high calorie foods at literally every turn. What makes an average, healthy adult different from an obese adult? Increased ghrelin and decreased leptin.

Ghrelin is the appetite stimulating hormone produced in the fundus (large rounded bottom area of the stomach). This hormone is said to be extra prevalent in obese people. If you have never dealt with a weight issue, try to imagine this: never feeling satisfied. It is worse when we diet. Our body is used to a certain amount of food so when we decrease what we eat, our bodies literally tell us we're starving. Diets don't always work! Actually, talk to any bariatric patient and they will yell at you, "DIETS NEVER WORK!"

If you think I (and I'm speaking for anyone thinking about weight loss surgery) "just" have a problem with will power and my lack of exercise, guess what? It's more than that. I have more ghrelin in my body which makes me more hungry more often. I also have less leptin in my body which means I have little to help suppress my appetite. Because of this problem my metabolism is way off from the average sized adult.

So where does the Roux-En-Y gastric bypass come in and how does it help? The cutting of the stomach is the most drastic measure. The surgeon cuts off the fundus which cuts off the production of ghrelin. This means I won't have an appetite post surgery and instead of eating for a variety of reasons, it is just out of necessity and the satiety will finally be present.



Resources:
http://en.wikipedia.org/wiki/Ghrelin
http://en.wikipedia.org/wiki/Leptin
http://www.sciencedaily.com/releases/2009/05/090520055519.htm
Image borrowed from http://www.texashealth.org/body.cfm?id=1525