Editing Bariatrics rationale (section)

== '''Mechanism of action''' ==

* Enteroencephalic endocrine     axis
** Interplay between GIT and      brain to regulate food intake
** Hypothalamus is the key area
** NPY is the main hormonal      signal regulating energy intake, which is modulated by hormones secreted      by GIT cells, such as ghrelin and peptide YY
** Ghrelin is secreted by      fundus cells. It increases significantly before a meal and quickly      diminishes post-prandially. Ghrelin stimulates synthesis of NPY, creating      an orexigenic signal.
** Most studies show that      ghrelin levels fall significantly after LSG, but unclear after RYGB
* Enteroinsular endocrine axis
** Action of gut hormones to      induce insulin secretion and reduce glucagon secretion in response to      food
** Theoretically altered after      bariatric surgery, as earlier arrival of carbohydrate loads in ileum      stimulates peptides including GLP-1 and GIP
** Incompletely understood