Roux-en-Y gastric bypass surgery is an effective treatment for obesity by disrupting the endocannabinoid pathway signaling between the brain and gut.

“but in animal models this surgery has the same effect as Ramona bath and what's really fascinating is that if you take animals that have had this surgery and you give them these endocannabinoids it blocks partially blocks the effects of the surgery and they start getting fat again”

“exactly where these fat receptors are that's where the process of making these endocannabinoids happens so somewhere in the duodenum exactly”

“and it's happening because of this well-described mechanism that endocannabinoids control your stimulus to overeat”

“and then when you look at bariatric surgery or gastric bypass again it is CB1 blocking or lowering of CB1 activation in the gut that is why it works there are papers on this we're not making this up it's very clear”

“right so now we also have the treatment that we're left with one of the most effective treatments for obesity right now in humans and in animals is um gastric bypass surgery right the most effective one we have there is ruin y gastric bypass rydd and rygb surgery when it's effective and it doesn't work about 20 of the time but when it works it works because you're basically cutting the signal between the brain and the gut that enables this endocannabinoid pathway right and all of a sudden you stop craving junk food”

“what happens is linoleic acid breaks down into those in the human gut and there are receptors for those cannabinoids in the human gut which is crazy and it's corroborated by the fact that you can fix all this by a surgery that we do called gastric bypass so the weight gastric bypass works is you cut the stomach this is kind of um medieval but you cut the stomach at its intersection with the duodenum and you attach the stomach further down on the small intestine maybe somewhere in the jejunum or the distal duodenum so basically what you're doing is you're creating a blind Loop of bowel does that make sense you have the duodenum where it attaches to the stomach and you're taking this duodenum you're making a blind Loop of bowel you're bypassing all these uh and and all these endogenous cannabinoid receptors and you connect the stomach down lower right so if you eat linoleic acid now you missed all of these receptors that fixes satiety like almost instantly people become insulin sensitive overnight with the surgery they lose weight immediately their satiety goes through the roof because you're bypassing all those receptors”

“one of the most successful operations for the treatment of both obesity and type 2 diabetes is a gastric bypass what happens in a patient and this is kind of a remarkable operation in the sense that in an instant their upper gi tract is rerouted it's not like they had months and months to adapt to something new i mean there obviously is an adaptation post-op but it's an immediate change”