PhD Defence Jennifer Amely Wilbrink

Keywords: Satiety hormones, obesity, metabolic or bariatric surgery 
 

"Exploring the role of gastrointestinal brake mechanisms in the management of obesity with focus on bariatric surgery"

This thesis examined gut hormone secretion, gastric emptying, small bowel transit, gut barrier function, and gut bacteria in obesity and after weight loss surgery. It also reviewed intestinal brake mechanisms—feedback systems regulating appetite via hormonal and neural pathways. 

In obesity, the gut barrier in the stomach and duodenum is impaired, allowing harmful bacteria to enter the bloodstream and trigger inflammation. Gut bacteria composition is also altered. 

After sleeve gastrectomy and gastric bypass, gastric emptying and satiety hormones (GLP-1, PYY) increased, reducing appetite. Small bowel transit accelerated only after sleeve gastrectomy. Post-surgery, the gut barrier improved, inflammation decreased, and gut bacteria changed. 

In conclusion, obesity is associated with reduced satiety, impaired gut barrier, and altered gut microbiota. Weight loss surgery improves these parameters, contributing to appetite reduction and better health. 

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