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While shedding even a substantial amount of weight is increasingly achievable through the use of fitness and nutrition tracking tech, those suffering from severe obesity often require a more drastic form of intervention. Staple weight-loss strategies like starting a new exercise regimen, or cutting calories aren’t always effective, or even physically feasible for morbidly obese individuals carrying over a hundred pounds of excess body weight.


Facing extreme threats to their well-being, over 200,000 Americans annually choose to undertake surgical intervention. Bariatric surgery involves altering the stomach so that appetite is reduced and fewer calories are consumed and absorbed. As an emergency tactic, bariatric surgery validates itself by virtue of its results: morbidly obese patients who undergo bariatric procedures often experience tangible weight loss, and can be up to 40% less likely to die prematurely.


Gastric bypass surgery is widely considered the “gold standard” of bariatric methods due to its comparatively high success rate; the procedure involves realigning portions of the stomach and intestines to effectively “bypass” a large part of the digestive tract, thereby limiting absorption of calories and nutrients.


Not only does the surgery alter the physical makeup of the human gut, new research suggests it also rearranges patients’ microbial profile in a massive way; according to a recent study backed by the National Institute of Health and conducted by experts at Arizona State University, patients who receive gastric bypass surgery cultivate in their digestive tracts an entirely different (and permanent) microbiome, full of beneficial, weight-loss promoting bacteria.


The realignment of gastric bypass patients’ digestive system leaves a far less acidic and more oxygenated environment, one in which organisms such as Lactobacillus–normally a native of the mouth–can survive. Lactobacillus, and other new residents of surgery patients’ stomachs, promote weight loss by releasing molecules which activate appetite-suppressing hormones, and induce other neurological reactions that curb the urge to eat.


It’s possible that this microbial reconfiguration might actually be responsible for much, or even all, of the weight loss experienced by bypass patients. Such assertions, while unproven, are nonetheless promising, as previous experiments found that obese mice with normal stomachs that received transplants of bypass-induced weight-loss microbes shed as much weight as the mice that had the operation.


Rose Krajmalnik-Brown, head of the Arizona State study, says she hopes to find a way to establish in humans the microbiome caused by gastric bypass, only without the surgery. “My vision is to figure out a way to first treat the gut to create the right environment for this microbiome to establish itself,” says Krajmalnik-Brown.


If a dose of healthy microbes could achieve dramatic weight-loss without reorganizing the structure of the stomach, many obese people who would rather avoid the dangers and side effects of complex surgeries would undoubtedly benefit.