Study protocol. Study protocol. A: Study design. Ten candidates for RYGB were studied in an acute intervention study. All participants underwent four test.

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Study protocol. Study protocol. A: Study design. Ten candidates for RYGB were studied in an acute intervention study. All participants underwent four test visits: two before RYGB and two 4 weeks after RYGB. During two visits (one before and one after RYGB), the GLP-1 receptor antagonist Ex9-39 was infused in order to block actions of endogenous GLP-1. During the other visits, only placebo (saline) was infused. B: Test visit. The infusion started 1 h before the beginning of the scan and lasted until the end of the visit. During each visit, two fMRI scans were performed: one while fasted and one 30 min after intake of a standardized meal. During both the fMRI scans, visual food cues were presented, whereas a task with gustatory food cues was presented only during the postprandial fMRI scan. Blood samples were drawn and sensation of hunger, fullness, and appetite were scored on a 10-point Likert scale at fixed time points. Plac, placebo; T1, structural MRI T1 weighted sequence; V1–4, test visits 1–4. Jennifer S. ten Kulve et al. Dia Care 2017;40:1522-1529 ©2017 by American Diabetes Association