Association Between Appetite-Regulating Hormonal Levels and Body Composition Among Adults With Pre-operative Bed Undergoing Bariatric Surgery: A Prospective Cohort Study Protocol
Bibliographic record
Abstract
Introduction: Severe obesity, defined by a body mass index (BMI) of >35 kg/m2, is a health concern affecting one in eight individuals worldwide and one in three Canadians (1, 2, 3). Metabolic bariatric surgery (MBS) is a safe and effective treatment that offers long-term success compared to conventional methods like pharmacotherapy and behavioural control. However, post-operative weight regain remains common, particularly among MBS candidates with binge-eating disorder (BED). The objective of this study is to comparatively examine the association of appetite-regulation hormones, namely ghrelin and leptin, with post-laparoscopic sleeve gastrectomy (LSG) and post-Roux-en-Y gastric bypass (RYGB) weight maintenance and binge-eating behaviours among individuals with preoperative BED. Methods: This is a prospective cohort study to examine changes in ghrelin and leptin levels in adult patients with pre-operative BED undergoing LSG or RYGB. A total of 90 will be recruited from bariatric centers of excellence in Ontario, Canada. Summary statistics and anthropometrics will be measured pre-operatively and at 1, 3-, 6-, 12-, and 24-months post-surgery. Binge eating will be assessed using the Binge Eating Scale (BES). Anticipated Results: Ghrelin and leptin levels will vary by surgery type, due to RYGB’s association with higher 24-month ghrelin levels than LSG. Lower 12-month post-MBS BES scores will predict lower weight regain 24-months post-MBS. Weight loss is anticipated in both groups, with no significant difference based on surgery type. Discussion: The study aims to examine the influence of surgery type-specific ghrelin and leptin levels on binge-eating behavior and post-operative weight maintenance. Differences in hormonal regulation and weight regain between LSG and RYGB patients may be correlated, given that RYGB patients are reported to experience more favourable long-term outcomes. Elevated ghrelin levels post-RYGB are paradoxically associated with lower BED symptoms, potentially promoting long-term weight stability. These findings could inform personalized post-operative care strategies and promote long-term hormonal monitoring/therapy. Conclusion: Understanding the hormonal mechanisms underlying post-MBS weight regain and binge-eating behaviours helps optimize long-term patient outcomes. Long-term research on the stability of ghrelin and leptin levels, and the influences of other appetite-regulating hormones, would provide insight into sustained metabolic changes post-MBS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".