Fig. 2

LSG regulates energy metabolism through central and peripheral mechanisms. At the central level, LSG enhances hypothalamic POMC neuron activity while suppressing NPY/AgRP neuronal signaling to reduce appetite. The procedure has minimal impact on vagal nerve signaling pathways. Peripheral mechanisms involve significant alterations in gut hormone secretion: elevated GLP-1 and PYY levels suppress hunger, whereas reduced ghrelin secretion diminishes hunger signaling. Postoperative body composition remodeling is characterized by decreased visceral fat, accompanied by increased adiponectin and reduced leptin, which collectively improve insulin sensitivity and alleviate lipid metabolism disorders