The belly of the beasts

Af­ter weight-loss surgery the gut mi­cro­biome can fail to flour­ish. AN­DREW MASTER­SON re­ports.

Cosmos - - Digest -

Gas­tric by­pass surgery per­ma­nently changes the make-up of mi­cro­bial com­mu­ni­ties in the gut, new re­search shows. Pre­vi­ous stud­ies have es­tab­lished that obe­sity is linked to re­duced di­ver­sity of gut mi­crobe species – which has a neg­a­tive im­pact on health, be­cause the bac­te­ria in our bel­lies is crit­i­cal for ef­fi­cient di­ges­tion.

The new study, led by Zehra Esra Il­han and Rosa Kra­j­mal­nik-brown of Ari­zona State Univer­sity, in the US, set out to de­ter­mine the ef­fects on mi­cro­bial di­ver­sity of two pop­u­lar weight-loss pro­ce­dures: Roux-en-y gas­tric by­pass (RYGB), and la­paro­scopic ad­justable gas­tric band­ing (LAGB). RYGB is the more ag­gres­sive in­ter­ven­tion, and is ir­re­versible. The team dis­cov­ered that af­ter weight-loss prompted by the by­pass surgery, most pa­tients gut mi­cro­biota un­der­went pro­found change.

The new bac­te­rial ecol­ogy was dif­fer­ent to those of both obese and nor­mal-weight peo­ple, but it was also highly di­verse – a sign of an ef­fi­cient sys­tem. “Di­ver­sity is good be­cause of what we call func­tional re­dun­dancy. If you have 10 work­ers that can do the same job, when one of them gets sick, the job still gets done,” Kra­j­mal­nikBrown notes.

Gas­tric by­pass surgery is an ef­fec­tive long-term weight-loss strat­egy for obese and mor­bidly obese peo­ple. How­ever, it doesn’t work in ev­ery case, with some pa­tients con­tin­u­ing to gain weight af­ter the op­er­a­tion. Il­han sus­pects this might re­flect a fail­ure of the gut mi­cro­biome to flour­ish. She sug­gests that fur­ther re­search might find a way to avoid the in­va­sive and risky pro­ce­dure, re­plac­ing it with a bac­te­ria-friendly in­fu­sion. “A pro­bi­otic that would re­place surgery would be great,” she says. The re­search was pub­lished in The ISMA Jour­nal.

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