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Gut hormones also play a crucial role, as evidenced by the rapid normalization of blood glucose in individuals with T2D shortly after MBS, even before significant WL occurs ( While MBS efficacy has been widely investigated, the reasons for a suboptimal clinical response, in particular whether gut hormones also play a role in WR or T2D relapse is less well established ( 2 Materials and methods 2.1 Participant selection The study participants were identified from our retrospective cohort study that evaluated WL and comorbidity remission at 10 or more years after RYGB surgery ( 2.1.1 Cohort 1 Analysis of hormone profiles of individuals with different weight trajectories (n=23) To focus on weight trajectories analysis, we defined the inclusion criteria as individuals with no history of T2D who achieved optimal WL - defined as a TWL greater than 20% within two years after surgery