Evolution of body composition of obese patients undergoing bariatric surgery

Luís Bernardo Silva; Bruno M P M Oliveira; Flora Correia

doi:10.1016/j.clnesp.2019.02.002

Evolution of body composition of obese patients undergoing bariatric surgery

Clin Nutr ESPEN. 2019 Jun:31:95-99. doi: 10.1016/j.clnesp.2019.02.002. Epub 2019 Mar 20.

Authors

Luís Bernardo Silva¹, Bruno M P M Oliveira², Flora Correia³

Affiliations

¹ Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; Sociedade Portuguesa de Ciências da Nutrição e Alimentação, Portugal.
² Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; LIAAD, INESC TEC, Portugal.
³ Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Portugal; Sociedade Portuguesa de Ciências da Nutrição e Alimentação, Portugal; Centro Hospitalar de São João E.P.E, Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Portugal. Electronic address: floracorreia@fcna.up.pt.

PMID: 31060840
DOI: 10.1016/j.clnesp.2019.02.002

Abstract

Background & aims: Bariatric surgery is increasingly common in the fight against morbid obesity. However, after this intervention, it is not fully understood the evolution of weight loss and how body composition changes. The objective of this work is to study the evolution after surgery of weight and body composition of obese patients that underwent bariatric surgery.

Methods: In this retrospective and prospective study, we studied initially BMI and body composition of obese patients who attended nutritional appointments at Centro Hospitalar São João E.P.E. We collected personal data and anthropometric measurements between the pre-surgery appointment up to 60 months after surgery.

Results: The sample consisted of 793 patients, of which 86.5% were female and 13.5% were male, with a mean age of 43 years (SD = 10.5 years) and mean height of 1.62 m (SD = 0.079 m). Patients undergoing gastric band, sleeve gastrectomy and gastric bypass had, respectively, an initial BMI reduction of 6.3 kg/m², 13.2 kg/m² and 15.4 kg/m² and an initial fat mass% reduction of 4.4%, 14.3% and 17.3%. On the other hand, they had an initial increase of 3.2%, 10.8% and 12.4% of water%, 1.4%, 3.9% and 4.6% of fat and water-free mass%, and 1.9%, 7.3% and 8.9% of skeletal muscle mass%, respectively. BMI and fat mass% on average had a large decrease in the first 12 months, increasing slightly from 24 months onwards. The opposite behaviour was observed for water%, fat and water-free mass% and skeletal muscle mass%.

Conclusions: Bariatric surgery initially allows a substantial decrease in BMI as well as beneficial changes in the overall body composition of the individuals. Gastric bypass was the method that caused the most changes, followed by sleeve gastrectomy and, finally, gastric band. On average, after 24 months of follow-up, and for all surgical procedures studied, we observed a reversion in BMI and body composition values, showing the difficulties in maintaining weight and fat loss.

Keywords: Bariatric surgery; Body composition; Gastric band; Gastric bypass; Obesity; Sleeve gastrectomy.

MeSH terms

Adult
Bariatric Surgery*
Body Composition*
Body Mass Index
Female
Gastrectomy
Gastric Bypass
Humans
Male
Middle Aged
Muscle, Skeletal
Obesity, Morbid / surgery*
Prospective Studies
Retrospective Studies
Weight Loss*