Insights into the underlying mechanisms and improved efficacy of bariatric surgery

Bariatric surgery, including laparoscopic adjustable gastric banding, roux-en-y gastric bypass and vertical sleeve gastrectomy remains the only effective treatment for morbid obesity that delivers sustained weight loss and ameliorates associated co-morbidities. Notions of restriction and malabsorption were initially proposed to explain the efficacy of these procedures, but it is now clear that there is a complex interplay between the gut and the brain that underlies the metabolic improvements following bariatric surgery. This thesis aims to provide insights into the underlying mechanisms and improved efficacy of bariatric surgical procedures.