The Importance of the Microbiome in Bariatric Surgery: a Systematic Review

  • Josianne C. H. B. M. Luijten
  • Guusje Vugts
  • Grard A. P. Nieuwenhuijzen
  • Misha D. P. LuyerEmail author
Review Article


Bariatric surgery results in sustained weight loss, improvement of metabolic and hormonal changes, and reduction of comorbidities in obese patients. However, beneficial effects of bariatric surgery are not solely explained by restriction and malabsorption induced by surgery itself. Changes in the microbiome might play a role in this mechanism. A systematic review was performed in which 21 studies were included. The microbiome was affected by surgery and profound changes occurred in the first year of follow-up. An increase in Bacteroides and Proteobacteria and a decrease in Firmicutes were observed postoperatively in most studies. These changes were associated with weight loss. Bariatric surgery induces profound changes in the microbiome. This may be related to the beneficial effect of bariatric surgery on comorbidities associated with obesity.


Gut microbiome Bariatric surgery Comorbidities Type 2 diabetes Weight loss Roux-en-Y gastric bypass (RYGB) Sleeve gastrectomy (SG) 


Author Contributions

All authors equally contributed to this paper. Conception and design of the study: ML and GN; literature review and analysis: JL and GV; drafting and critical revision and editing, and final approval of the final version: JL, GV, ML, and GN.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statements Regarding Ethics and Consent

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of ResearchNetherlands Comprehensive Cancer Organization (IKNL)UtrechtThe Netherlands
  2. 2.Department of SurgeryCatharina HospitalEindhovenThe Netherlands

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