The Gut Microbiota as a Mediator of Metabolic Benefits after Bariatric Surgery

Bariatric surgery is based on major anatomic rearrangements in the gastrointestinal tract that coincide with functional and taxonomic changes in gut microbial communities. These alterations in gut anatomy and in the microbiota are associated with early resolution of obesity-related impairment of glycemic control and are marked weight loss in the long term. Moreover, altered bile acid metabolism has been implicated in the control of energy homeostasis, emerging as a pivotal orchestrator in the gut microbiota-mediated effects of bariatric surgery. In this review, we summarize the growing body of evidence linking changes in the gut microbiota to the metabolic benefits of bariatric surgery and discuss the potential mechanisms involved.