fMRI and Appetite-Related Hormones Pre and Post Obesity Surgery

NCT ID: NCT01583725

Last Updated: 2024-08-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-07-31

Study Completion Date

2015-07-31

Brief Summary

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The investigators are looking at the differences in appetite and obesity between weight loss participants and patients undergoing bariatric surgery.

Obese persons between the ages of 18 \& 65 are eligible to participate in this study, whether or not they intend to undergo bariatric surgery.

Detailed Description

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Currently, the only effective long term treatment for severe obesity is bariatric surgery.2 Nearly 200,000 procedures are performed each year, with this number increasing rapidly.3 However, the mechanisms of reduced food intake and weight loss after obesity surgery, particularly Rouen-Y gastric bypass (RYGB), are not well understood. This study utilizes functional magnetic resonance imaging (fMRI) and measures of appetite-related gut peptide levels pre and post bariatric surgery to investigate the neurological and hormonal mechanisms involved in initiation and termination of meals.

The general objective is to better understand the physiological changes resulting in weight loss from obesity surgery, particularly Roux-en-Y gastric bypass (RYGB). The main hypothesis is that the differential mechanisms of action in RYGB will alter the signals involved in the initiation and termination of meals, reflected by changes in both peptide hormone levels and regional brain activity in response to foods. The investigators anticipate that the trigger for meal initiation by potent food stimuli will be diminished following RYGB, as indicated by reduced brain activation in areas associated with food reward and motor planning, including the orbitofrontal cortex (OFC). RYGB will be compared to: a. Gastric Banding (GB), representing the restrictive component of surgery, which itself enhances fullness, but in the absence of any rerouting of the gut, should result in fewer changes in gut peptide levels and brain activation; b. Weight Loss (WL) on a formula diet over 3 mo, which represents the weight loss component of surgery; and c. No Treatment (NT), a general control, with no gastric restriction or weight loss. These group comparisons will help parse the contributions of RYGB surgery to weight loss.

The plan is to study clinically severe obese subjects (S's) pre surgery, and at 3 and 18 mo post surgery. The investigators will examine: 1) fMRI brain activation in response to food stimuli and 2) appetite-related gut peptide levels before and following a fixed meal prior to the fMRI. The findings should reveal potential mechanisms associated with the changes in appetite, eating behaviors, and body weight, both during the rapid weight loss phase at 3 mo post surgery as well as when weight typically stabilizes at a nadir at 18 mo post surgery. The investigators plan to enroll 160 patients: 40 with RYGB, 40 GB, 40 WL, and 40 NT (4-arm study). S's will be within the BMI range of 40-50 and matched across groups for BMI, gender (3:1, f:m), and BED status.

Conditions

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Obesity

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Roux-en-Y Gastric Bypass

30 subjects who plan to undergo Roux-en-Y Gastric Bypass bariatric surgery. Liquid meal responses and Behavioral fMRI responses to food-cues will be assessed before surgery (T1), 3 months (T2) and 18 months (T3) after surgery.

Group Type EXPERIMENTAL

Liquid meal responses

Intervention Type PROCEDURE

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

fMRI responses to food-cues

Intervention Type BEHAVIORAL

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

Gastric Banding (Lap-band)

30 subjects who plan to undergo Gastric Banding bariatric surgery. Liquid meal responses and Behavioral fMRI responses to food-cues will be assessed before surgery (T1), 3 months (T2) and 18 months (T3) after surgery.

Group Type EXPERIMENTAL

Liquid meal responses

Intervention Type PROCEDURE

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

fMRI responses to food-cues

Intervention Type BEHAVIORAL

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

Formula Diet Weight Loss

30 subjects who plan to begin a formula diet to lose weight. Liquid meal responses and Behavioral fMRI responses to food-cues will be assessed before subjects undertake a 12-week weight loss intervention (T1), at the end of the weight loss intervention (T2) and 18 months after they completed the weight loss intervention(T3).

Group Type EXPERIMENTAL

Liquid meal responses

Intervention Type PROCEDURE

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

fMRI responses to food-cues

Intervention Type BEHAVIORAL

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

No Treatment

30 subjects who do not undergo any treatment for weight loss. Liquid meal responses and Behavioral fMRI responses to food-cues will be assessed at baseline (T1) and at 3 months (T2) and 18 months (T3) later.

Group Type EXPERIMENTAL

Liquid meal responses

Intervention Type PROCEDURE

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

fMRI responses to food-cues

Intervention Type BEHAVIORAL

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

Sleeve Gastrectomy Surgery

30 subjects who plan to undergo Sleeve Gastrectomy bariatric surgery. Liquid meal responses and Behavioral fMRI responses to food-cues will be assessed before surgery (T1), 3 months (T2) and 18 months (T3) after surgery.

Group Type EXPERIMENTAL

Liquid meal responses

Intervention Type PROCEDURE

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

fMRI responses to food-cues

Intervention Type BEHAVIORAL

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

Interventions

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Liquid meal responses

Subject ingests a meal-replacement shake and gut peptide levels are measured before and after intake.

Intervention Type PROCEDURE

fMRI responses to food-cues

Subjects undergo a 40 min fMRI neuroimaging session while receiving auditory and visual food cues.

Intervention Type BEHAVIORAL

Other Intervention Names

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Meal replacement shake is the product Glytrol. Food cue responses

Eligibility Criteria

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Inclusion Criteria

* BMI range 35-50 kg/m\^2

Exclusion Criteria

* diabetes,
* smoking,
* pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Columbia University

OTHER

Sponsor Role collaborator

St. Luke's-Roosevelt Hospital Center

OTHER

Sponsor Role collaborator

New York Obesity and Nutrition Research Center

OTHER

Sponsor Role lead

Responsible Party

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Dr. Allan Geliebter

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Allan Geliebter, PhD

Role: PRINCIPAL_INVESTIGATOR

New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital, Columbia University

Locations

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St. Luke's-Roosevelt Hospital Center

New York, New York, United States

Site Status

Countries

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United States

References

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Ongur D, Price JL. The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans. Cereb Cortex. 2000 Mar;10(3):206-19. doi: 10.1093/cercor/10.3.206.

Reference Type BACKGROUND
PMID: 10731217 (View on PubMed)

Le DS, Pannacciulli N, Chen K, Del Parigi A, Salbe AD, Reiman EM, Krakoff J. Less activation of the left dorsolateral prefrontal cortex in response to a meal: a feature of obesity. Am J Clin Nutr. 2006 Oct;84(4):725-31. doi: 10.1093/ajcn/84.4.725.

Reference Type BACKGROUND
PMID: 17023697 (View on PubMed)

Le DS, Pannacciulli N, Chen K, Salbe AD, Del Parigi A, Hill JO, Wing RR, Reiman EM, Krakoff J. Less activation in the left dorsolateral prefrontal cortex in the reanalysis of the response to a meal in obese than in lean women and its association with successful weight loss. Am J Clin Nutr. 2007 Sep;86(3):573-9. doi: 10.1093/ajcn/86.3.573.

Reference Type BACKGROUND
PMID: 17823419 (View on PubMed)

Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med. 1997 Aug 7;337(6):396-407. doi: 10.1056/NEJM199708073370606. No abstract available.

Reference Type BACKGROUND
PMID: 9241130 (View on PubMed)

Whitson BA, Leslie DB, Kellogg TA, Maddaus MA, Buchwald H, Billington CJ, Ikramuddin S. Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study. J Surg Res. 2007 Jul;141(1):31-9. doi: 10.1016/j.jss.2007.02.022.

Reference Type BACKGROUND
PMID: 17574036 (View on PubMed)

Korner J, Bessler M, Cirilo LJ, Conwell IM, Daud A, Restuccia NL, Wardlaw SL. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin. J Clin Endocrinol Metab. 2005 Jan;90(1):359-65. doi: 10.1210/jc.2004-1076. Epub 2004 Oct 13.

Reference Type BACKGROUND
PMID: 15483088 (View on PubMed)

le Roux CW, Welbourn R, Werling M, Osborne A, Kokkinos A, Laurenius A, Lonroth H, Fandriks L, Ghatei MA, Bloom SR, Olbers T. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann Surg. 2007 Nov;246(5):780-5. doi: 10.1097/SLA.0b013e3180caa3e3.

Reference Type BACKGROUND
PMID: 17968169 (View on PubMed)

Sorbara M, Geliebter A. Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Int J Eat Disord. 2002 May;31(4):416-23. doi: 10.1002/eat.10046.

Reference Type BACKGROUND
PMID: 11948646 (View on PubMed)

Jirik-Babb P, Geliebter A. Comparison of psychological characteristics of binging and nonbinging obese, adult, female outpatients. Eat Weight Disord. 2003 Jun;8(2):173-7. doi: 10.1007/BF03325009.

Reference Type BACKGROUND
PMID: 12880197 (View on PubMed)

Erdmann J, Topsch R, Lippl F, Gussmann P, Schusdziarra V. Postprandial response of plasma ghrelin levels to various test meals in relation to food intake, plasma insulin, and glucose. J Clin Endocrinol Metab. 2004 Jun;89(6):3048-54. doi: 10.1210/jc.2003-031610.

Reference Type BACKGROUND
PMID: 15181097 (View on PubMed)

Marzullo P, Verti B, Savia G, Walker GE, Guzzaloni G, Tagliaferri M, Di Blasio A, Liuzzi A. The relationship between active ghrelin levels and human obesity involves alterations in resting energy expenditure. J Clin Endocrinol Metab. 2004 Feb;89(2):936-9. doi: 10.1210/jc.2003-031328.

Reference Type BACKGROUND
PMID: 14764817 (View on PubMed)

Hosoda H, Doi K, Nagaya N, Okumura H, Nakagawa E, Enomoto M, Ono F, Kangawa K. Optimum collection and storage conditions for ghrelin measurements: octanoyl modification of ghrelin is rapidly hydrolyzed to desacyl ghrelin in blood samples. Clin Chem. 2004 Jun;50(6):1077-80. doi: 10.1373/clinchem.2003.025841. No abstract available.

Reference Type BACKGROUND
PMID: 15161728 (View on PubMed)

Liu J, Prudom CE, Nass R, Pezzoli SS, Oliveri MC, Johnson ML, Veldhuis P, Gordon DA, Howard AD, Witcher DR, Geysen HM, Gaylinn BD, Thorner MO. Novel ghrelin assays provide evidence for independent regulation of ghrelin acylation and secretion in healthy young men. J Clin Endocrinol Metab. 2008 May;93(5):1980-7. doi: 10.1210/jc.2007-2235. Epub 2008 Mar 18.

Reference Type BACKGROUND
PMID: 18349056 (View on PubMed)

Geliebter A, Ladell T, Logan M, Schneider T, Sharafi M, Hirsch J. Responsivity to food stimuli in obese and lean binge eaters using functional MRI. Appetite. 2006 Jan;46(1):31-5. doi: 10.1016/j.appet.2005.09.002. Epub 2005 Dec 20.

Reference Type BACKGROUND
PMID: 16364498 (View on PubMed)

Related Links

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http://www.nyorc.org/

New York Obesity Nutrition Research Center website

Other Identifiers

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09-101

Identifier Type: -

Identifier Source: org_study_id

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