Evidence map›Paper›PMID 33965350›Full record

ReviewSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery2021

Ockham's razor and the metabolic syndrome.

Walter J Pories, Terry E Jones, Joseph A Houmard, Eric DeMaria, G Lynis Dohm

Open access · greenAbstract readReview
In one paragraph

Review in Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. GLP-1: The Progenitor Hormone.Obesity surgery · 2025
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Walter J PoriesDepartment of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina. Electronic address: poriesw@ecu.edu.
Terry E JonesCollege of Allied Health Sciences, East Carolina University, Greenville, North Carolina.
Joseph A HoumardDepartment of Kinesiology, East Carolina University, Greenville, North Carolina.
Eric DeMariaDepartment of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
G Lynis DohmDepartment of Physiology, East Carolina University, Greenville, North Carolina.
East Carolina University · US

Funding

East Carolina University Bariatric Surgery Clinical CenterU01DK066526 · NIDDK · EAST CAROLINA UNIVERSITY · PI PORIES, WALTER JULIUS · 2003 to 2015
$4.0M
Metabolic inflexibility is related to elevated muscle anaerobic glycolysisR01DK120296 · NIDDK · EAST CAROLINA UNIVERSITY · PI BROSKEY, NICHOLAS, HOUMARD, JOSEPH A · 2019 to 2023
$2.6M
Prescribed Exercise to Reduce Recidivism After Weight LossR56HL132961 · NHLBI · EAST CAROLINA UNIVERSITY · PI SWIFT, DAMON LEO · 2018 to 2018
$736k
NHLBI NIH HHS R56 HL132961NIDDK NIH HHS R01 DK120296NIDDK NIH HHS U01 DK066526
6 · The paper itself

Abstract

The broad effects of bariatric/metabolic surgery on virtually every tissue and organ system remain unexplained. Weight loss, although a major factor, does not fully account for the rapid, full, and durable remission of type 2 diabetes, return of islet function, reduction of the prevalence of cancers, increase in gray matter of the brain, and decrease in all-cause mortality. This review supports the thesis that the metabolic syndrome is not a group of separate diseases but rather multiple expressions of a shared defect in the utilization of carbohydrates and lipids. That error is probably caused by a dysmetabolic signal from the foregut, stimulated by food, that limits entry of 2-carbon fragments into the tricarboxylic acid cycle, the accumulation of lactate and, in turn, increases in glucose and insulin. Surgery limits that signal by reducing contact between food and foregut mucosa. Speciation of that signal(s) may offer a new pathway for drug development.

Indexed as

Bariatric SurgeryDiabetes Mellitus, Type 2Gastric BypassMetabolic SyndromeObesity, MorbidHumansInsulinWeight LossInsulinBariatric surgeryGastric bypassGastric sleeveLactateMetabolicMetabolic syndromeType 2 diabetes

Identifiers

PMID33965350
PMCPMC9069669
OpenAlexW3157008405

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.