Does Menopause Affect Outcomes from Roux-en-Y Gastric Bypass Surgery?

Estradiol increases body weight loss and satiation effects of Roux-en-Y gastric bypass (RYGB) in ovariectomized rats, according to the August issue of Gastroenterology.

Approximately ~85% of bariatric surgery procedures are performed on women, but little is known about the effects of menopause or reproductive hormones, such as estrogen, on outcomes.

Lori Asarian et al. performed RYGB surgeries on female rats that had been fattened for 3 weeks on a high-energy diet and then had their ovaries removed, to model menopause. The rats were then placed on varying diets and some were given physiologic amounts of estradiol (a form of estrogen).

The authors found that the estradiol significantly increased the ability of RYGB to reduce food intake and body weight gain, independently of what type of diet the rats were offered after the surgery (see figure).

Body weight (top) and food intake (bottom) following RYGB or a sham operation in ovariectomized rats given estradiol (E2) or oil (as a control). Significant differences were observed in SHAM-OIL vs RYGB-OIL (#); RYGB-OIL vs RYGB-E2 (*); and SHAM-OIL vs SHAM-E2 (+).

They also provided evidence that estrogen increased the satiating effects of the intestinal hormones glucagon-like peptide 1 (GLP-1, which stimulates insulin secretion and makes people feel full) and cholecystokinin (which causes release of digestive enzymes and suppresses hunger).

Asarian et al. concluded that RYGB surgery might be more effective for healthy pre-menopausal women (or post-menopausal women who receive hormone replacement therapy) than women with lower levels of estrogen.

It is not clear whether estrogens promote the effects of RYGB by the same mechanisms by which they contribute to the normal control of eating and body weight. Further experiments are also needed to determine whether estrogens affect outcomes from other types of bariatric surgeries, such as gastric banding or gastric sleeve resection.

Read the article online.
Asarian L, Abegg K, Geary N, et al. Estradiol increases body weight loss and gut-peptide satiation after roux-en-y gastric bypass in ovariectomized rats. Gastroenterology 2012;143:325–327.e2.

6 Comments

  1. Avatar
    ajay gunshettiwar chandrapur india August 24, 2012

    Vomiting with blood for last 6 month

    • Avatar
      Elizabeth Evans January 30, 2013

      Please tell me more. Respectfully Yours.E.Evans

  2. Avatar
    Cheryl Pitts December 04, 2013

    I am almost 50 and am entering menopause I had Roux-en-Y gastric bypass surgery almost 10 years ago. I have kept the weight off but am experiencing flushness in my face and hands is this normal affects from hot flashes as you enter menopause? I can feel swealing in my nose and mouth and hands just prior to turning bright red! This is embarassing but not sure if I need to be concerned or if normal. Can I get more info please?

  3. Avatar
    Kathy June 29, 2019

    I have Roux-en Y gastric bypass 16 years ago… I kept the weight off until 2015 when I went through menopause. I have gained 50lbs since then and am trying desperately to lose it. Any suggestions?

    • Avatar
      KM September 22, 2019

      I wish I had advice. I’m definitely up at least 10 in the last year since my period has stopped and I really restrict what I eat. I am also experiencing lots of inflammation which is effecting my athletic pursuits in a huge and bad way. I’ve gotten arthritis and bursitis. It is so discouraging. I’m afraid I will gain more. You are not alone. <3

  4. Avatar
    Carol Ledbetter October 04, 2019

    I had lapband in 2008, removed in 2013, went to sleeve (had stricture) conveyed to bypass in 2016. I’ve had a 30 lb gain since late 2017(in one months time). Still considered in perimenopause stage as of late 2019. Of course all tests cine back in “normal” range, was told welcome to middle age. Nothing works. Don’t know what to do……

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