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Journal of Obesity
Volume 2016, Article ID 4390254, 8 pages
Review Article

Bile Acids, FXR, and Metabolic Effects of Bariatric Surgery

1Temple University School of Medicine, Philadelphia, PA 19140, USA
2Penn State College of Medicine, Hershey, PA 17033, USA
3Geisinger Clinic, Danville, PA 17822, USA

Received 29 October 2015; Accepted 31 January 2016

Academic Editor: Francesco Saverio Papadia

Copyright © 2016 Olivier F. Noel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Overweight and obesity represent major risk factors for diabetes and related metabolic diseases. Obesity is associated with a chronic and progressive inflammatory response leading to the development of insulin resistance and type 2 diabetes (T2D) mellitus, although the precise mechanism mediating this inflammatory process remains poorly understood. The most effective intervention for the treatment of obesity, bariatric surgery, leads to glucose normalization and remission of T2D. Recent work in both clinical studies and animal models supports bile acids (BAs) as key mediators of these effects. BAs are involved in lipid and glucose homeostasis primarily via the farnesoid X receptor (FXR) transcription factor. BAs are also involved in regulating genes involved in inflammation, obesity, and lipid metabolism. Here, we review the novel role of BAs in bariatric surgery and the intersection between BAs and immune, obesity, weight loss, and lipid metabolism genes.