Australian researchers find gastric sleeve surgery could be avoided with the same results

The most popular type of weight-loss surgery doesn’t work by simply making a person’s stomach smaller but also activates the brain and — incredibly — ­recruits the “good fat” in the body, Melbourne researchers have found.

The most popular type of weight-loss surgery doesn’t work by simply making a person’s stomach smaller, Australian researchers have found.

In research to be presented this week, Melbourne scientists have found gastric sleeve surgery activates the brain and — incredibly — ­recruits the “good fat” in the body to burn energy and ­contribute to the procedure’s success.

The Monash University ­researchers are now working on ways to harness the weight-loss power of the nervous ­system-driven process without the need for the radical ­surgery.

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About 25,000 Australians had a sleeve gastrectomy this year, the most common bariatric surgery, in which up to 80 per cent of their stomach is surgically removed.

Dr Aneta Stefanidis, from the Monash Biomedicine Discovery Institute, will present new preclinical data at the Australasian Neuroscience Society’s meeting tomorrow, showing that the surgery triggers the recruitment and activation of brown fat to expend energy.

Babies have ample stores of brown fat, which burns energy rather than storing it like white fat, but a decade ago, it was found it also exists in smaller amounts in the shoulders and neck of adults, sparking a race to harness these fat cells for weight loss.

“We have been able to show that if you remove the impact of brown fat, we see up to a 50 per cent reduction in the body weight loss that occurs following the gastric sleeve,” Dr Stefanidis said.

Gastric sleeve operations help their recipients to lose huge amounts of weight.

“Just days following gastric sleeve surgery, we see an activation of brown fat, even before substantial weight loss … suggesting there are mechanisms independent of weight loss engaging the recruitment of brown fat.”

Despite the gastric sleeve surgery removing most of the stomach, the nerve communication between the gut and the brain persists.

Dr Stefanidis said their work had shown that recruitment of brown fat most likely occurred through this gut-brain communication via the vagus nerve, one of the most important nerves in the body.

Implantable devices that electrically stimulate the nerve are already used, or in research development, to treat conditions such as epilepsy, gastrointestinal conditions and headaches.

As the Monash team is now working with colleagues at The Alfred to see whether their findings in animals can be replicated in human patients, they are also now working to individually stimulate the different nerve fibres between the gut and brain to unlock the best target for replicating the effects of gastric sleeve surgery, including turning on the brown fat.

Researchers have found it is not just the surgery that helps bring about the weight loss.

“This research is significant because it’s important for clinicians to understand how these surgeries work to refine them,” Dr Stefanidis said.

“Patients will also be much more receptive to undergoing these procedures if they understand how it’s going to make them lose weight.

“But surgery is not a practical approach at the population level — our aim now is to identify a specific target, a medicinal, mechanical approach or a device, to circumvent the need to cut such a substantial portion of the stomach away and get the same impact on metabolic outcomes as sleeve gastrectomy surgery.”

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