BACKGROUND: Bariatric surgery has become a common treatment for morbid obesity. The relative changes in body tissue that comprise the substantial weight loss over time are not completely understood. METHODS: We evaluated the differential rates of fat and lean tissue losses in morbidly obese patients who underwent Roux-en-Y gastric bypass surgery. Body composition was assessed using whole-body dual energy X-ray absorptiometry (DXA) performed at two timepoints in the postoperative period. Patients were stratified by the tertile of rapidity of weight loss expressed as percent reduction in body mass index per month. RESULTS: Thirty two patients (25 women, 7 men) with a mean age of 46.7 +/- 10.4 years and an average initial body weight of 141.4 +/- 29.4 kg experienced a 52.3 +/- 16.6 kg (36.5 +/- 5.5%) weight loss over 13.9 +/- 6.0 months. The incremental rates of lean body mass loss by tertiles were 0.3 +/- 0.6, 0.5 +/- 0.2, and 1.0 +/- 0.8 kg/month (P = 0.02), whereas the rates of fat loss were 1.2 +/- 0.9, 1.8 +/- 0.4, and 2.9 +/- 1.0 kg/month (P = 0.0001). The ratios for lean to fat loss among the respective tertiles were 1:4.0, 1:3.6, and 1:3.0. The correlation between rates of lean and fat mass loss was r = 0.37 (P = 0.04). Only three of the 32 patients (9.4%) patients maintained or gained lean mass following Roux-en-Y gastric bypass surgery. CONCLUSIONS: After bariatric surgery, those patients losing weight at the greatest rate appear to have accelerated losses of both lean and fat mass. Few patients maintain lean body mass after bariatric surgery, despite self-reported participation in conventional exercise programs. These data suggest the need for more aggressive interventions to preserve lean body mass during the weight loss phase after Roux-en-Y gastric bypass surgery.
BACKGROUND: Bariatric surgery has become a common treatment for morbid obesity. The relative changes in body tissue that comprise the substantial weight loss over time are not completely understood. METHODS: We evaluated the differential rates of fat and lean tissue losses in morbidly obesepatients who underwent Roux-en-Y gastric bypass surgery. Body composition was assessed using whole-body dual energy X-ray absorptiometry (DXA) performed at two timepoints in the postoperative period. Patients were stratified by the tertile of rapidity of weight loss expressed as percent reduction in body mass index per month. RESULTS: Thirty two patients (25 women, 7 men) with a mean age of 46.7 +/- 10.4 years and an average initial body weight of 141.4 +/- 29.4 kg experienced a 52.3 +/- 16.6 kg (36.5 +/- 5.5%) weight loss over 13.9 +/- 6.0 months. The incremental rates of lean body mass loss by tertiles were 0.3 +/- 0.6, 0.5 +/- 0.2, and 1.0 +/- 0.8 kg/month (P = 0.02), whereas the rates of fat loss were 1.2 +/- 0.9, 1.8 +/- 0.4, and 2.9 +/- 1.0 kg/month (P = 0.0001). The ratios for lean to fat loss among the respective tertiles were 1:4.0, 1:3.6, and 1:3.0. The correlation between rates of lean and fat mass loss was r = 0.37 (P = 0.04). Only three of the 32 patients (9.4%) patients maintained or gained lean mass following Roux-en-Y gastric bypass surgery. CONCLUSIONS: After bariatric surgery, those patients losing weight at the greatest rate appear to have accelerated losses of both lean and fat mass. Few patients maintain lean body mass after bariatric surgery, despite self-reported participation in conventional exercise programs. These data suggest the need for more aggressive interventions to preserve lean body mass during the weight loss phase after Roux-en-Y gastric bypass surgery.
Authors: Andrew R Luhrs; Gerardo Davalos; Reginald Lerebours; Jin Yoo; Chan Park; Lawrence Tabone; Philip Omotosho; Alfonso Torquati; Dana Portenier; Alfredo D Guerron Journal: Surg Endosc Date: 2019-06-17 Impact factor: 4.584
Authors: Lisa S Chow; Emily N C Manoogian; Alison Alvear; Jason G Fleischer; Honoree Thor; Katrina Dietsche; Qi Wang; James S Hodges; Nicholas Esch; Samar Malaeb; Tasma Harindhanavudhi; K Sreekumaran Nair; Satchidananda Panda; Douglas G Mashek Journal: Obesity (Silver Spring) Date: 2020-04-09 Impact factor: 5.002
Authors: Helena Julià; David Benaiges; Paula Mollà; Juan Pedro-Botet; Montserrat Villatoro; Laia Fontané; Jose M Ramon; Elisenda Climent; Juana A Flores Le Roux; Alberto Goday Journal: Obes Surg Date: 2019-08 Impact factor: 4.129
Authors: Diana L Alba; Lucy Wu; Peggy M Cawthon; Kathleen Mulligan; Thomas Lang; Sheena Patel; Nicole J King; Jonathan T Carter; Stanley J Rogers; Andrew M Posselt; Lygia Stewart; Dolores M Shoback; Anne L Schafer Journal: J Clin Endocrinol Metab Date: 2019-03-01 Impact factor: 5.958