{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:54:03Z","timestamp":1787061243351,"version":"build-2736575974"},"reference-count":90,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The persisting use of opioids following bariatric surgery has emerged as a prevalent complication, heightening the probability of opioid-related harm (ORM), such as opioid-related fatalities and prescription opioid use disorder (OUD). A comprehensive review of PubMed literature from 1990 to 2023 was conducted to pinpoint physiological influences on postoperative ORM. As a result, we found that patients undertaking bariatric operations often exhibit an inherently higher risk for substance use disorders, likely attributable to genetic predisposition and related neurobiological changes that engender obesity and addiction-like tendencies. Furthermore, chronic pain is a common post-bariatric surgery complaint, and the surgical type impacts opioid needs, with increased long-term opioid use after surgeries. Additionally, the subjective nature of pain perception in patients with obesity can distort pain reporting and the corresponding opioid prescription both before and after surgery. Furthermore, the postoperative alterations to the gastrointestinal structure can affect the microbiome and opioid absorption rates, resulting in fluctuating systemic exposure to orally ingested opioids. The prospect of ORM development post-bariatric surgery appears amplified due to a preexisting susceptibility to addictive habits, surgically induced pain, modified gut\u2013brain interaction and pain management and the changed pharmacokinetics post-surgery. Further research is warranted to clarify these potential risk variables for ORM, specifically OUD, in the bariatric population.<\/jats:p>","DOI":"10.3390\/jcm12134296","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T02:11:22Z","timestamp":1687831882000},"page":"4296","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Opioid Analgesics after Bariatric Surgery: A Scoping Review to Evaluate Physiological Risk Factors for Opioid-Related Harm"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9511-155X","authenticated-orcid":false,"given":"Stephanie C. M.","family":"Wuyts","sequence":"first","affiliation":[{"name":"Pharmacy Department, Universitair Ziekenhuis Brussel (UZ Brussel), 1090 Brussels, Belgium"},{"name":"Research Group Clinical Pharmacology and Clinical Pharmacy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Torensma","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7715-5209","authenticated-orcid":false,"given":"Arnt F. A.","family":"Schellekens","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis (Kees)","family":"Kramers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Pharmacology-Toxicology, Radboud University Nijmegen Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/FTD.0000000000000789","article-title":"Is Europe facing an emerging opioid crisis comparable to the U.S.?","volume":"43","author":"Pierce","year":"2021","journal-title":"Drug Monit."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e498","DOI":"10.1016\/S2468-2667(19)30128-8","article-title":"Trends in use and misuse of opioids in the Netherlands: A retrospective, multi-source database study","volume":"4","author":"Kalkman","year":"2019","journal-title":"Lancet Public Health"},{"key":"ref_3","first-page":"Cd012592","article-title":"Opioids for cancer pain\u2014An overview of Cochrane reviews","volume":"7","author":"Wiffen","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","first-page":"Cd012299","article-title":"High-dose opioids for chronic non-cancer pain: An overview of Cochrane Reviews","volume":"3","author":"Els","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1192\/j.eurpsy.2021.2219","article-title":"Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018","volume":"64","author":"Pierce","year":"2021","journal-title":"Eur. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kalkman, G.A., Kramers, C., van Dongen, R.T., Schers, H.J., van Boekel, R.L.M., Bos, J.M., Hek, K., Schellekens, A.F.A., and Atsma, F. (2023). Practice variation in opioid prescribing for non-cancer pain in Dutch primary care: A retrospective database study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282222"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6501e1","article-title":"CDC Guideline for prescribing opioids for chronic pain\u2014United States, 2016","volume":"65","author":"Dowell","year":"2016","journal-title":"MMWR Recomm. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1111\/dar.13441","article-title":"Health harms of non-medical prescription opioid use: A systematic review","volume":"41","author":"Werb","year":"2022","journal-title":"Drug Alcohol Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/j.1526-4637.2007.00370.x","article-title":"What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse\/addiction and\/or aberrant drug-related behaviors? A structured evidence-based review","volume":"9","author":"Fishbain","year":"2008","journal-title":"Pain Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/AJP.0000000000000021","article-title":"The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain: The role of opioid prescription","volume":"30","author":"Edlund","year":"2014","journal-title":"Clin. J. Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1001\/jamasurg.2021.6210","article-title":"Current issues in the use of opioids for the management of postoperative pain: A review","volume":"157","author":"Macintyre","year":"2022","journal-title":"JAMA Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/EJA.0000000000001346","article-title":"Persistent postoperative opioid use in Europe: A systematic review","volume":"38","author":"Sitter","year":"2021","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e207367","DOI":"10.1001\/jamanetworkopen.2020.7367","article-title":"Rate and Risk Factors Associated with Prolonged Opioid Use After Surgery: A Systematic Review and Meta-analysis","volume":"3","author":"Lawal","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e170504","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Neff, K.J., Olbers, T., and le Roux, C.W. (2013). Bariatric surgery: The challenges with candidate selection, individualizing treatment and clinical outcomes. BMC Med., 11.","DOI":"10.1186\/1741-7015-11-8"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1007\/s11695-020-05207-7","article-title":"Bariatric surgery Survey 2018: Similarities and disparities among the 5 IFSO chapters","volume":"31","author":"Angrisani","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s00464-022-09291-x","article-title":"New persistent opioid use after bariatric surgery: A systematic review and pooled proportion meta-analysis","volume":"37","author":"Nasser","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1001\/jama.2013.278344","article-title":"Chronic use of opioid medications before and after bariatric surgery","volume":"310","author":"Raebel","year":"2013","journal-title":"JAMA"},{"key":"ref_19","first-page":"1247","article-title":"Chronic opioid use emerging after bariatric surgery","volume":"23","author":"Raebel","year":"2014","journal-title":"Pharm. Drug Saf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1016\/j.soard.2017.04.003","article-title":"Use of prescribed opioids before and after bariatric surgery: Prospective evidence from a U.S. multicenter cohort study","volume":"13","author":"King","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3518","DOI":"10.1007\/s11695-018-3377-7","article-title":"Use of opioid analgesics before and after gastric bypass surgery in Sweden: A population-based study","volume":"28","author":"Szabo","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.amjsurg.2020.03.019","article-title":"Influence of preoperative psychotropic medications on opioid requirements and outcomes following bariatric surgery","volume":"219","author":"Sheldon","year":"2020","journal-title":"Am. J. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1007\/s11695-013-0998-8","article-title":"Challenges in the optimisation of post-operative pain management with opioids in obese patients: A literature review","volume":"23","author":"Lopes","year":"2013","journal-title":"Obes. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1007\/s40265-019-01156-3","article-title":"Perioperative Pain Management in Morbid Obesity","volume":"79","author":"Belcaid","year":"2019","journal-title":"Drugs"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11096-005-6034-x","article-title":"Prescription errors with cytotoxic drugs and the inadequacy of existing classifications","volume":"27","author":"Slama","year":"2005","journal-title":"Pharm. World Sci. PWS"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6312","DOI":"10.1007\/s00464-022-09035-x","article-title":"Hospital opioid use predicts the need for discharge opioid prescriptions following laparoscopic bariatric surgery","volume":"36","author":"Diaz","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Iranmanesh, P., Barlow, K., and Anvari, M. (2023). The effect of bariatric surgery on opioid consumption in patients with obesity: A registry-based cohort study. Surg. Obes. Relat. Dis., online ahead of print.","DOI":"10.1016\/j.soard.2023.03.004"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e552","DOI":"10.1097\/SLA.0000000000005192","article-title":"Opioid use after gastric bypass, sleeve gastrectomy or intensive lifestyle intervention","volume":"277","author":"Bruze","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1001\/jama.2012.6147","article-title":"Prevalence of alcohol use disorders before and after bariatric surgery","volume":"307","author":"King","year":"2012","journal-title":"JAMA"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.soard.2012.07.001","article-title":"Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study","volume":"8","author":"Mitchell","year":"2012","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1007\/s11695-023-06564-9","article-title":"Pre-operative substance use disorder is associated with higher risk of long-term mortality following bariatric surgery","volume":"33","author":"Kim","year":"2023","journal-title":"Obes. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1007\/s11695-022-06400-6","article-title":"Incidence of substance use disorder following bariatric surgery: A retrospective cohort study","volume":"33","author":"Butt","year":"2023","journal-title":"Obes. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jpsychires.2016.01.009","article-title":"Substance use after bariatric surgery: A review","volume":"76","author":"Li","year":"2016","journal-title":"J. Psychiatr. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1007\/s11695-014-1317-8","article-title":"New-onset substance use disorder after gastric bypass surgery: Rates and associated characteristics","volume":"24","author":"Ivezaj","year":"2014","journal-title":"Obes. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s00464-022-09481-7","article-title":"Opioid prescribing practices following bariatric surgery: A systematic review and pooled proportion meta-analysis","volume":"37","author":"Lin","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9313","DOI":"10.1007\/s00464-022-09205-x","article-title":"Patient characteristics and outcomes among bariatric surgery patients with high narcotic overdose scores","volume":"36","author":"Yang","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1017\/S0033291721000969","article-title":"Genetics of substance use disorders: A review","volume":"51","author":"Deak","year":"2021","journal-title":"Psychol. Med."},{"key":"ref_38","first-page":"452","article-title":"Multi-variant genetic panel for genetic risk of opioid addiction","volume":"47","author":"Donaldson","year":"2017","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_39","first-page":"S2-001","article-title":"Neuro-genetics of Reward Deficiency Syndrome (RDS) as the root cause of \u201cAddiction Transfer\u201d: A new phenomenon common after bariatric surgery","volume":"3","author":"Blum","year":"2012","journal-title":"J. Genet. Syndr. Gene"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1038\/nrn.2017.130","article-title":"The dopamine motive system: Implications for drug and food addiction","volume":"18","author":"Volkow","year":"2017","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1515\/sjpain-2019-0092","article-title":"Chronic abdominal pain and persistent opioid use after bariatric surgery","volume":"20","author":"Simoni","year":"2020","journal-title":"Scand. J. Pain"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s11695-022-06354-9","article-title":"Cross-sectional E-survey on the incidence of pre- and postoperative chronic pain in bariatric surgery","volume":"33","author":"Torensma","year":"2023","journal-title":"Obes. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.soard.2020.04.037","article-title":"Long-term opioid use after bariatric surgery","volume":"16","author":"Maciejewski","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/s41367-019-0011-7","article-title":"Gut microbiota: A new path to treat obesity","volume":"9","author":"Muscogiuri","year":"2019","journal-title":"Int. J. Obes. Suppl."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/FBP.0000000000000538","article-title":"The role of the gut microbiome in opioid use","volume":"31","author":"Ren","year":"2020","journal-title":"Behav. Pharm."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"147835","DOI":"10.1016\/j.brainres.2022.147835","article-title":"The future of neuroimaging and gut-brain axis research for substance use disorders","volume":"1781","author":"Montesinos","year":"2022","journal-title":"Brain Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/PRS.0000000000005084","article-title":"Persistent opioid use and high-risk prescribing in body contouring patients","volume":"143","author":"Bennett","year":"2019","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s11695-015-2008-9","article-title":"Pain experience and perception in the obese subject: Systematic review (Revised version)","volume":"26","author":"Torensma","year":"2016","journal-title":"Obes. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.soard.2017.01.015","article-title":"Pain sensitivity and pain scoring in patients with morbid obesity","volume":"13","author":"Torensma","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.soard.2018.11.019","article-title":"Opioids and bariatric surgery: A review and suggested recommendations for assessment and risk reduction","volume":"15","author":"Heinberg","year":"2019","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1111\/obr.12869","article-title":"The influence of bariatric surgery on oral drug bioavailability in patients with obesity: A systematic review","volume":"20","author":"Angeles","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/apt.12872","article-title":"Review article: The nutritional and pharmacological consequences of obesity surgery","volume":"40","author":"Stein","year":"2014","journal-title":"Aliment. Pharm."},{"key":"ref_53","unstructured":"Yska, J.P. (2017). Exploring Optimal Pharmacotherapy after Bariatric Surgery: Where Two Worlds Meet. [Ph.D. Thesis, Rijksuniversiteit Groningen]."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1007\/s11695-016-2535-z","article-title":"RYGB and drug disposition: How to do better? Analysis of pharmacokinetic studies and recommendations for clinical practice","volume":"27","author":"Hachon","year":"2017","journal-title":"Obes. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1111\/j.1365-2125.2012.04284.x","article-title":"Trends in oral drug bioavailability following bariatric surgery: Examining the variable extent of impact on exposure of different drug classes","volume":"74","author":"Darwich","year":"2012","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s40262-015-0259-1","article-title":"Altered drug disposition following bariatric surgery: A research challenge","volume":"54","author":"Greenblatt","year":"2015","journal-title":"Clin. Pharm."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.neubiorev.2015.06.012","article-title":"How fast and how often: The pharmacokinetics of drug use are decisive in addiction","volume":"56","author":"Allain","year":"2015","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s40262-014-0163-0","article-title":"Effect of a Roux-en-Y gastric bypass on the pharmacokinetics of oral morphine using a population approach","volume":"53","author":"Hirt","year":"2014","journal-title":"Clin. Pharm."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1016\/j.soard.2017.07.030","article-title":"Morphine and metabolites plasma levels after administration of sustained release morphine in Roux-en-Y gastric bypass subjects versus matched control subjects","volume":"13","author":"Hachon","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/bcpt.13634","article-title":"Effect of Roux-en-Y gastric bypass on the pharmacokinetic-pharmacodynamic relationships of liquid and controlled-release formulations of oxycodone","volume":"129","author":"Ladebo","year":"2021","journal-title":"Basic. Clin. Pharmacol. Toxicol."},{"key":"ref_61","first-page":"3126","article-title":"The pharmacokinetics of oral oxycodone in patients after total gastric resection","volume":"18","author":"Karbownik","year":"2014","journal-title":"Eur. Rev. Med. Pharm. Sci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1016\/j.clinthera.2020.08.016","article-title":"Effect of sleeve gastrectomy on buprenorphine pharmacokinetics: A planned case observation","volume":"42","author":"Krabseth","year":"2020","journal-title":"Clin. Ther."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1016\/j.clinthera.2016.04.033","article-title":"Bioavailability of methadone after sleeve gastrectomy: A planned case observation","volume":"38","author":"Helland","year":"2016","journal-title":"Clin. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.phrs.2016.08.031","article-title":"The effect of morbid obesity on morphine glucuronidation","volume":"118","author":"Luo","year":"2017","journal-title":"Pharm. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/2049463712439132","article-title":"Opioids, pain and addiction-practical strategies","volume":"6","author":"Jovey","year":"2012","journal-title":"Br. J. Pain"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1038\/mp.2015.153","article-title":"Weight loss after bariatric surgery normalizes brain opioid receptors in morbid obesity","volume":"21","author":"Karlsson","year":"2016","journal-title":"Mol. Psychiatry"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"McGregor, M., Hamilton, J., Hajnal, A., and Thanos, P.K. (2019). Roux-en-Y gastric bypass in rat reduces mu-opioid receptor levels in brain regions associated with stress and energy regulation. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0218680"},{"key":"ref_68","first-page":"620","article-title":"Suppressed fat appetite after Roux-en-Y gastric bypass surgery associates with reduced brain \u03bc-opioid receptor availability in diet-induced obese male rats","volume":"10","author":"Hankir","year":"2016","journal-title":"Front. Neurosci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3193","DOI":"10.1210\/jc.2015-1783","article-title":"Endogenous opioid mechanisms are implicated in obesity and weight loss in humans","volume":"100","author":"Burghardt","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1001\/jamasurg.2013.3654","article-title":"The effectiveness and risks of bariatric surgery: An updated systematic review and meta-analysis, 2003\u20132012","volume":"149","author":"Chang","year":"2014","journal-title":"JAMA Surg."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Martinou, E., Stefanova, I., Iosif, E., and Angelidi, A.M. (2022). Neurohormonal changes in the gut-brain axis and underlying neuroendocrine mechanisms following bariatric surgery. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23063339"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1007\/s11695-022-05982-5","article-title":"Antrum preservation versus antrum resection in laparoscopic sleeve gastrectomy with effects on gastric emptying, body mass index, and Type II diabetes remission in diabetic patients with body massi ndex 30\u201340 kg\/m2: A randomized controlled study","volume":"32","author":"Eskandaros","year":"2022","journal-title":"Obes. Surg."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.soard.2020.10.018","article-title":"Differences in the effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass on gut hormones: Systematic and meta-analysis","volume":"17","author":"Gu","year":"2021","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1007\/s11695-022-05983-4","article-title":"Dialectical behavior therapy for emotional and mindless eating after bariatric surgery: A prospective exploratoru cohort study","volume":"32","author":"Hany","year":"2022","journal-title":"Obes. Surg."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Farhadipour, M., and Depoortere, I. (2021). The function of bastrointestinal hormones in obesity-Implications for the regulation of energy intake. Nutrients, 13.","DOI":"10.3390\/nu13061839"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/SLA.0000000000003614","article-title":"Effect of sleeve gastrectomy on Ghrelin, GLP-1, PYY, and GIP gut hormones: A systematic review and meta-analysis","volume":"272","author":"McCarty","year":"2020","journal-title":"Ann. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e2231593","DOI":"10.1001\/jamanetworkopen.2022.31593","article-title":"A 7-year study of the durability of improvements in pain, physical function, and work productivity after Roux-en-Y gastric bypass and sleeve gastrectomy","volume":"5","author":"King","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Chahal-Kummen, M., V\u00e5ge, V., Kristinsson, J.A., and Mala, T. (2023). Chronic abdominal pain and quality of life after Roux-en-Y gastric bypass and sleeve gastrectomy\u2014A cross-cohort analysis of two prospective longitudinal observational studies. Surg. Obes. Relat. Dis., online ahead of print.","DOI":"10.1016\/j.soard.2023.01.020"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"3860","DOI":"10.1007\/s11695-019-04056-3","article-title":"Roux limb motility in gastric bypass patients with chronic abdominal pain-Is there an association to prescribed ppioids?","volume":"29","author":"Maleckas","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1097\/SLA.0b013e3181dbb572","article-title":"Bariatric surgery-induced weight loss reduces hepatic lipid peroxidation levels and affects hepatic cytochrome P-450 protein content","volume":"251","author":"Bell","year":"2010","journal-title":"Ann. Surg."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s00268-021-06394-9","article-title":"Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: A 2021 update","volume":"46","author":"Stenberg","year":"2022","journal-title":"World J. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1016\/j.soard.2020.07.016","article-title":"Does ERAS impact outcomes of laparoscopic sleeve gastrectomy in adolescents?","volume":"16","author":"Yalcin","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"4919","DOI":"10.1007\/s11695-020-04980-9","article-title":"An opioid-sparing protocol improves recovery time and reduces opioid use after laparoscopic sleeve gastrectomy","volume":"30","author":"Pardue","year":"2020","journal-title":"Obes. Surg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1016\/j.soard.2021.04.017","article-title":"Enhanced recovery after surgery for sleeve gastrectomies: Improved patient outcomes","volume":"17","author":"Sapin","year":"2021","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2896","DOI":"10.1007\/s11695-021-05338-5","article-title":"Reduction in opiate use, pain, nausea, and length of stay after implementation of a bariatric Enhanced Recovery After Surgery protocol","volume":"31","author":"Monte","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1007\/s00464-022-09646-4","article-title":"Effectiveness of Bariatric Surgery Targeting Opioid Prescriptions (BSTOP) protocol on postoperative pain control","volume":"37","author":"Seu","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.soard.2022.11.011","article-title":"How much narcotics are really needed after bariatric surgery: Results of a prospective study","volume":"19","author":"Wilson","year":"2023","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"3103","DOI":"10.1007\/s00464-022-09482-6","article-title":"Implementation of a standardized multimodal pain regimen significantly reduces postoperative inpatient opioid utilization in patients undergoing bariatric surgery","volume":"37","author":"Tan","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.soard.2013.01.016","article-title":"Pilot evaluation of a substance abuse prevention group intervention for at-risk bariatric surgery candidates","volume":"9","author":"Ashton","year":"2013","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/oby.23646","article-title":"Long-term all-cause and cause-specific mortality for four bariatric surgery procedures","volume":"31","author":"Adams","year":"2023","journal-title":"Obesity"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/13\/4296\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:01:32Z","timestamp":1760126492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/13\/4296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,27]]},"references-count":90,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12134296"],"URL":"https:\/\/doi.org\/10.3390\/jcm12134296","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,27]]}}}