Table 1 Physiological changes after the most commonly performed bariatric surgery procedures and modern obesity and type 2 diabetes mellitus pharmacotherapy

	RYGB	VSG	AGB	Orlistat	Lorcaserin	Phentermine/topiramate	GLP-1 agonists	DPP-4 inhibitors	SGLT-2 inhibitors	Pramlintide
Appetite	↓	↓	↓	↔/↑	↓	↓	↓	↔	?	↓
Plasma ghrelin	↑/↓/↔	↓	↑	↔/↑	?	?	↓	↔	?	↔
Plasma GLP-1	↑	↑	↔	↔/↑	?	?	↑	↑	?	↓
Plasma PYY	↑	↑	↔	↔/↓	?	?	↓ fasting levels	↓ PYY_3–36/↔	?	↔/↓
Plasma Oxyntomodulin	↑	?	?	?	?	?	?	?	?	?
Plasma CCK	↔	↔/↑	?	↔/↓	?	?	?	?	?	↔/↓
Plasma leptin	↓	↓	↓	↓	?	?	↓	?	?	↓
Gastric emptying	↑/↓	↑	↔	↑	?	?	↓	↔	?	↓
Caloric malabsorption	Minimal for fat only	?	?	↑	?	?	?	?	?	?
Energy expenditure	↑/↓/↔	↔	?	↓	↓	?	?	?	?	↑/↔
Food preferences	↓ Consumption of fat and sugar	↓ Consumption of fat and sugar	↔ Or ↑consumption of fat and sugar	↓ Consumption of fat necessary	?	?	↓ consumption of fat and sugar	?	?	↔/↓consumption of fat
Glycaemic improvements	Early and sustained, weight-dependent and -independent	Early and sustained, weight-dependent and -independent	Gradual and sustained, weight-dependent	Gradual	Gradual	Gradual	Early and gradual alongside weight loss	Early and sustained	Early and sustained	Early and gradual alongside weight loss
Early postprandial insulin release	↑, Early and sustained	↑, Early and sustained	↔	↑, Gradual	?	?	↑	↔/↑	?	↓
Insulin resistance	↓	↓	↓	↓	↓	↓	↓	↔	↓	↓
Plasma bile acids	↑	↑	↔	?	?	?	?	?	?	?
Gut microbiota	Significant changes	?	?	?	?	?	?	?	?	?

Abbreviations: AGB, adjustable gastric banding; CCK, cholecystokinin; DPP, dipeptidyl peptidase; GLP-1, glucagon-like peptide-1; PYY, peptide YY; RYGB, Roux-en-Y gastric bypass; SGLT, sodium-glucose co-transporter; VSG, vertical sleeve gastrectomy; ↑, increase in parameter; ↓, decrease; ↔, no change; ?, not known.
Evidence has been provided predominantly by human and, when that was not available, animal studies.

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