changes may help explain quality-of-life and psychological declines after bariatric surgery.
Evidence
This narrative review synthesizes adult Roux-en-Y gastric bypass and sleeve gastrectomy studies on psychological measures, gut-derived hormones, and microbiota.
Caveat
The abstract classifies the evidence as Level III-IV and frames GLP-1/PYY, vagal, and microbiota mechanisms as potential correlates rather than proven causes.
Simplified
PURPOSE: Bariatric surgery has proven effective in enhancing metabolic health and achieving sustainable weight loss for individuals with obesity. However, some patients experience adverse psychological outcomes and reduced quality-of-life post-surgery, potentially linked to changes in the . This review aims to synthesize current evidence on the interplay between bariatric surgery-induced gut-brain axis modifications and patients' psychological status.
METHODS: A systematic literature search was conducted across PubMed, Web of Science, and Embase, prioritizing clinical studies, mechanistic investigations, and meta-analyses. Inclusion criteria encompassed English-language articles examining psychological parameters, gut-derived hormones, and gut microbiota in adults after Roux-en-Y gastric bypass or sleeve gastrectomy.
RESULTS: Bariatric surgery fundamentally reprograms gut-brain communication through anatomical, endocrine, and neural plasticity mechanisms, a process associated with dual-edged metabolic benefits and neuropsychiatric risks. Mechanistic analyses suggest that postoperative dysregulation of GLP-1/PYY secretion, altered vagal afferent signaling, and sustained microbiota dysbiosis (reduced Bifidobacterium, elevated Proteobacteria) may represent potential correlates of these outcomes.
CONCLUSIONS: Studies have demonstrated significant associations between mood, quality of life, psychological status, and gut-derived hormones or microbiota. A comprehensive understanding of how bariatric surgery impacts gut-brain signaling pathways is critical for optimizing long-term therapeutic outcomes and enhancing patient quality of life.
LEVEL OF EVIDENCE: This manuscript is a Narrative Review. According to the grading criteria of the Oxford Centre for Evidence-Based Medicine (OCEBM), this manuscript is categorized as Level III-IV evidence.
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Gut-Brain Axis