عنوان

A translational study of the mechanisms for metabolic recovery after bariatric surgical intervention :

Number

TLets737724

Title Proper

A translational study of the mechanisms for metabolic recovery after bariatric surgical intervention :

General Material Designation

[Thesis]

First Statement of Responsibility

Martinez de la Escalera Clapp, Lucia

Title Proper by Another Author

from adipose mitochondria to patient benefit

Name of Publisher, Distributor, etc.

University of Warwick

Date of Publication, Distribution, etc.

2017

Dissertation or thesis details and type of degree

Ph.D.

Body granting the degree

University of Warwick

Text preceding or following the note

2017

Text of Note

The obesity pandemic is one of the greatest challenges facing public health worldwide. With epidemiological projections forecasting only its acceleration, it is clear that the current anti-obesity approach has not been effective. This thesis seeks to outline, through a translational approach, the various reasons for which the obesity crisis continues to grow and to provide further insight into which modifiable factors may contribute to more effective anti-obesity strategies. From the basic science perspective, this thesis investigated through cutting-edge laboratory technology some of the more novel and promising molecular mediators of metabolic recovery (namely gut-hormone FGF-19 and gut-derived bacterial LPS). In particular, this study contributes to a more in-depth understanding of adipose tissue mitochondria, and their role in buffering excess nutrients to maintain systemic metabolic health. From the clinical angle, this thesis explored through clinical audit some of the environmental barriers to metabolic recovery of patients undergoing treatment at a specialist bariatric service of a major NHS hospital. As a result of this translational approach, it was possible for the author to develop a profound appreciation of the complexities involved in developing an effective solution to the obesity crisis, which is rooted in two distinct (and sometimes opposite) concepts: (1) the medical and surgical treatment of obesity, targeting the physiological disorder through pharmacotherapy and/or surgery, and (2) the environmental management of obesity, targeting the dietetic, psychological, socio-economic and political causes through weight management and community development programs, industry regulation and public policy. Though often treated as separate, neither concept need be in conflict with the other. If the objective is truly to develop an effective solution to the obesity crisis, it is paramount to develop a trans-discipline community coordinated approach that addresses not just the cellular targets, but the environmental contributors to obesity.

RC Internal medicine

Martinez de la Escalera Clapp, Lucia

University of Warwick

Electronic name

p

[Thesis]

276903

a

Y