Bariatric Surgery

The New York Obesity Nutrition Research Center

BARIATRIC SURGERY

The Bariatric Interest Group includes:

Principal investigators: Drs. Domenico Accili, Paul Berk, Michael Devlin, Wendy Chung, Susan Carnell, Ilene Fennoy, Dympna Gallagher, Alan Geliebter, Paul Harris, Joy Hirsh, Kathleen Keller, Judy Korner, Donald Kotler, Blandine Laferrère, Rudy Leibel, Christopher Ochner, Xavier Pi-Sunyer, Gary Schwartz
Surgeons: Drs. Scott Belsley, Grace Kim, Ninan Koshy, James McGinty and Julio Teixeira at St. Luke’s-Roosevelt Hospital Center (SLRHC) and Drs. Mark Bessler, Daniel Davis, Beth Schrope, Akuezunkpa Ude, and Jeffrey Zistman (adolescents surgery), at Columbia University Medical Center (CUMC).

Research and procedures: Bariatric surgery results in significant and sustained weight loss, with considerable clinical improvement in obesity-associated comorbidities and diabetes remission in up to 80% of cases. The investigators in the Bariatric Interest Group are trying to understand the mechanisms of sustained weight loss and improved metabolism after various bariatric surgical procedures. We have 2 very active bariatric programs, one based at SLRHC and the other one at CUMC, with a total of 10 surgeons who perform between them ~ 800 yearly bariatric procedures, all laparoscopic:

gastric bypass (60%)
gastric banding (20%)
vertical sleeve gastrectomy (20%).

About 50 adolescent bariatric surgeries are performed each year by our bariatric surgeons.

Both bariatric centers are “Centers of Excellence” with high quality pre- and postoperative care and excellent clinical outcomes, monitored long term. The bariatric centers are essential to NYONRC clinical research studies, facilitating recruitment and allowing access to useful biospecimens (urine, blood, adipose tissue, liver, gastric and small bowel mucosa).

The interest group’s research interests range across virtually all aspects of the NYONRC’s activities, and make use of almost all Cores’ services.

Specific research projects during the past cycle, and anticipated in the next cycle, include:

Fatty acid fluxes in adipocytes and liver (P. Berk), liver steatosis (P. Berk, D. Kotler)
Randomization studies comparing different types of surgeries on diabetes outcome, coupled with glucose and insulin physiological studies (B. Laferrère)
Mechanisms of diabetes remission: incretins, gastric emptying, intestinal transit time (B. Laferrère)
Role of bile acids after gastric bypass surgery (B. Laferrère)
Gut microbiota and inflammation after bariatric surgery (B. Laferrère)
Meal pattern and gut peptide (GLP-1, GIP, PYY, ghrelin, CCK) response to mixed meal (B. Laferrère, J. Korner, A. Geliebter, F.X. Pi-Sunyer)
Safety and effectiveness of bariatric surgery in patients with diabetes and BMI< 35 kg/m2, randomization study GBP versus diet and intensive behavior management (J. Korner)
Brain activation by fMRI in response to meals (A. Geliebter, S. Carnell, C. Ochner)
Molecular physiology of the adipocyte from different depots (Y. Zhang)
Use of next-generation sequencing and copy-number variation analysis in adults (LABS at CUMP and SLRHC) and children (Teen-LABS) with extreme obesity (W. Chung). Study of gut brain interaction: development of bypass surgical models in rodent (G. Schwartz)
Change in FOX1 gut expression in DIO rodent models and obese humans after bypass surgery (D. Accili, G. Schwartz, B. Laferrère)
Leptin administration in failure after bariatric surgery (J. Korner, R. Leibel)
Stomach capacity, gastric stimulation and brain activation (J. Korner, A. Geliebter)
Body composition, fat mass, FFM and organ mass and energy expenditure (D. Gallagher)
The NIDDK’s Longitudinal Assessment of Bariatric Surgery (LABS) study in adults (P. Berk) and adolescents (J. Zistman, I. Fennoy)

Publications and Grants: With the very active and innovative surgical teams at SLRHC and CUMC, and the additional presence of the Chair of the NIH LABS (Dr.Berk), the bariatric interest group of the NYONRC has been extremely productive in basic, molecular genetics, animal and clinical research, with a total of 26 grants, and over 77 publications. Strong collaborations exist and/or are being developed not only among ORC investigators, but also with national and international scientists. It is expected that the number of funded projects around the bariatric theme will grow in strength, with both clinical and basic studies in the coming years.

Bariatric Minimally invasive surgery- St Luke’s Roosevelt Hospital Center