The Impact of Bariatric Surgery on the Muscle Mass in Patients with Obesity: 2-Year Follow-up

Abstract Purpose Bariatric surgery (BS) induces a significant and sustained weight loss in patients with severe obesity (SO). Nevertheless, apart from significantly reducing body fat, fat-free mass (FFM) might also be lost. At present, there is little and controversial data in the literature regarding the impact of BS on FFM. In recent years, bioimpedance (BIA) has emerged as a reliable test to assess body composition easily to use in the daily clinical practice. On the bases, the aim of the present study is to evaluate the impact of BS on the FFM, evaluated by means of BIA. Material and Methods This is a prospective, observational study, including consecutive patients with SO that underwent BS between February 2018 and February 2019 at our center. At baseline, 1, 6, 12, and 24 months after the BS, all the patients underwent complete medical history, physical and anthropometric evaluation, and body composition assessment by means of BIA (using Bodystat QuadScan4000®). Results Eighty-five patients with SO were recruited, 72.9% females, aged 45.54 ± 9.98 years, pre-BS BMI 43.87 ± 6.52 kg/m2. FFM significantly decreased continuously after BS at all timepoints. The loss of FFM 24 months post-BS accounted for approximately 21.71 ± 13.9% of the total weight loss, and was independent of BS technique or protein metabolism. Pre-BS HOMA-IR and FFM were independent predictors of FFM at 24 months. Conclusions Significant and early loss of FFM in patients with SO that undergo BS was seen, not related to protein metabolism parameters or the BS technique used, suggesting an independent mechanism. Graphical abstract

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Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

Obesity Surgery ◽

10.1007/s11695-021-05499-3 ◽

2021 ◽

Author(s):

Arnaud Liagre ◽

Francesco Martini ◽

Radwan Kassir ◽

Gildas Juglard ◽

Celine Hamid ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Severe Obesity ◽

Postoperative Mortality ◽

One Anastomosis Gastric Bypass ◽

Sustained Weight Loss ◽

Biliopancreatic Limb ◽

Percentage Excess Weight Loss

Abstract Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

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The effect of rapid weight loss on body composition and circulating markers of creatine metabolism in judokas

Kinesiology ◽

10.26582/k.51.2.3 ◽

2019 ◽

Vol 51 (2) ◽

pp. 158-160 ◽

Cited By ~ 2

Author(s):

Patrik Drid ◽

Saša Krstulović ◽

Marko Erceg ◽

Tatjana Trivić ◽

Marko Stojanović ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Fat Free Mass ◽

Rapid Weight Loss ◽

Significant Drop ◽

Circulating Markers ◽

Competition Period ◽

Food And Fluid Intake ◽

Creatine Metabolism

We evaluated the effects of a 7-day rapid weight loss (RWL) intervention on body composition and biomarkers of creatine metabolism in eight elite judokas during a pre-competition period. RWL induced a significant drop in weight (81.7±10.7 kg at baseline vs. 76.8 ± 10.3 kg at follow-up; p<.001), fat mass (12.6±5.6 kg vs. 9.2±4.0 kg; p=.003) and fat-free mass (69.1±7.3 kg vs. 67.6±7.7 kg; p=.05), accompanied by an increase in serum creatinine levels at follow-up (104.0±10.5 µmol/L vs. 114.9±10.2 µmol/L; p=.009). An acute restriction of food and fluid intake appears to negatively affect fat-free mass and indices of kidney function in judokas.

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Body Composition Changes After Very-Low-Calorie Ketogenic Diet in Obesity Evaluated by 3 Standardized Methods

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-2385 ◽

2016 ◽

Vol 102 (2) ◽

pp. 488-498 ◽

Cited By ~ 50

Author(s):

Diego Gomez-Arbelaez ◽

Diego Bellido ◽

Ana I. Castro ◽

Lucia Ordoñez-Mayan ◽

Jose Carreira ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Fat Mass ◽

Bioelectrical Impedance ◽

Fat Free Mass ◽

Obese Patients ◽

Body Composition Assessment ◽

Visceral Mass ◽

Low Calorie ◽

Composition Changes

Abstract Context: Common concerns when using low-calorie diets as a treatment for obesity are the reduction in fat-free mass, mostly muscular mass, that occurs together with the fat mass (FM) loss, and determining the best methodologies to evaluate body composition changes. Objective: This study aimed to evaluate the very-low-calorie ketogenic (VLCK) diet-induced changes in body composition of obese patients and to compare 3 different methodologies used to evaluate those changes. Design: Twenty obese patients followed a VLCK diet for 4 months. Body composition assessment was performed by dual-energy X-ray absorptiometry (DXA), multifrequency bioelectrical impedance (MF-BIA), and air displacement plethysmography (ADP) techniques. Muscular strength was also assessed. Measurements were performed at 4 points matched with the ketotic phases (basal, maximum ketosis, ketosis declining, and out of ketosis). Results: After 4 months the VLCK diet induced a −20.2 ± 4.5 kg weight loss, at expenses of reductions in fat mass (FM) of −16.5 ± 5.1 kg (DXA), −18.2 ± 5.8 kg (MF-BIA), and −17.7 ± 9.9 kg (ADP). A substantial decrease was also observed in the visceral FM. The mild but marked reduction in fat-free mass occurred at maximum ketosis, primarily as a result of changes in total body water, and was recovered thereafter. No changes in muscle strength were observed. A strong correlation was evidenced between the 3 methods of assessing body composition. Conclusion: The VLCK diet-induced weight loss was mainly at the expense of FM and visceral mass; muscle mass and strength were preserved. Of the 3 body composition techniques used, the MF-BIA method seems more convenient in the clinical setting.

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Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00185.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. E1080-E1088 ◽

Cited By ~ 102

Author(s):

Sai Krupa Das ◽

Susan B. Roberts ◽

Joseph J. Kehayias ◽

Jack Wang ◽

L. K. George Hsu ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Composition ◽

Reference Method ◽

Fat Free Mass ◽

Extreme Obesity ◽

Body Composition Assessment ◽

Air Displacement Plethysmography ◽

Time Points ◽

3C Model

Body composition methods were examined in 20 women [body mass index (BMI) 48.7 ± 8.8 kg/m2] before and after weight loss [−44.8 ± 14.6 (SD) kg] after gastric bypass (GBP) surgery. The reference method, a three-compartment (3C) model using body density by air displacement plethysmography and total body water (TBW) by H2 18O dilution (3C-H2 18O), showed a decrease in percent body fat (%BF) from 51.4 to 34.6%. Fat-free mass hydration was significantly higher than the reference value (0.738) in extreme obesity (0.756; P < 0.001) but not after weight reduction (0.747; P = 0.16). %BF by H2 18O dilution and air displacement plethysmography differed significantly from %BF by 3C-H2 18O in extreme obesity ( P< 0.05) and 3C models using 2H2O or bioelectrical impedance analysis (BIA) to determine TBW improved mean %BF estimates over most other methods at both time points. BIA results varied with the equation used, but BIA better predicted %BF than did BMI at both time points. All methods except BIA using the Segal equation were comparable to the reference method for determining changes over time. A simple 3C model utilizing air displacement plethysmography and BIA is useful for clinical evaluation in this population.

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The Impact of the COVID-19 Lockdown on Weight Loss and Body Composition in Subjects with Overweight and Obesity Participating in a Nationwide Weight-Loss Program: Impact of a Remote Consultation Follow-Up—The CO-RNPC Study

Nutrients ◽

10.3390/nu13072152 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2152

Author(s):

Sébastien Bailly ◽

Odile Fabre ◽

Rémy Legrand ◽

Laurent Pantagis ◽

Monique Mendelson ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Overweight And Obesity ◽

Weight Loss Program ◽

Dose Effect ◽

Remote Consultation ◽

Consultation Group ◽

The Impact ◽

Remote Consultations

The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we observed that the rate of weight loss was reduced during LD. This reduction was counterbalanced in participants involved in a remote consultation follow-up with a dose-effect response based on the number of remote consultations.

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Impact of food and fluid intake on technical and biological measurement error in body composition assessment methods in athletes

British Journal Of Nutrition ◽

10.1017/s0007114517000551 ◽

2017 ◽

Vol 117 (4) ◽

pp. 591-601 ◽

Cited By ~ 19

Author(s):

Ava Kerr ◽

Gary J. Slater ◽

Nuala Byrne

Keyword(s):

Body Composition ◽

Measurement Error ◽

Fluid Intake ◽

Bioelectrical Impedance ◽

Fat Free Mass ◽

Body Composition Assessment ◽

Change Scores ◽

Bod Pod ◽

The Impact ◽

Food And Fluid Intake

AbstractTwo, three and four compartment (2C, 3C and 4C) models of body composition are popular methods to measure fat mass (FM) and fat-free mass (FFM) in athletes. However, the impact of food and fluid intake on measurement error has not been established. The purpose of this study was to evaluate standardised (overnight fasted, rested and hydrated) v. non-standardised (afternoon and non-fasted) presentation on technical and biological error on surface anthropometry (SA), 2C, 3C and 4C models. In thirty-two athletic males, measures of SA, dual-energy X-ray absorptiometry (DXA), bioelectrical impedance spectroscopy (BIS) and air displacement plethysmography (BOD POD) were taken to establish 2C, 3C and 4C models. Tests were conducted after an overnight fast (duplicate), about 7 h later after ad libitum food and fluid intake, and repeated 24 h later before and after ingestion of a specified meal. Magnitudes of changes in the mean and typical errors of measurement were determined. Mean change scores for non-standardised presentation and post meal tests for FM were substantially large in BIS, SA, 3C and 4C models. For FFM, mean change scores for non-standardised conditions produced large changes for BIS, 3C and 4C models, small for DXA, trivial for BOD POD and SA. Models that included a total body water (TBW) value from BIS (3C and 4C) were more sensitive to TBW changes in non-standardised conditions than 2C models. Biological error is minimised in all models with standardised presentation but DXA and BOD POD are acceptable if acute food and fluid intake remains below 500 g.

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Effect of Thoracic Gas Volume Changes on Body Composition Assessed by Air Displacement Plethysmography after Rapid Weight Loss and Regain in Elite Collegiate Wrestlers

Sports ◽

10.3390/sports7020048 ◽

2019 ◽

Vol 7 (2) ◽

pp. 48 ◽

Cited By ~ 1

Author(s):

Emi Kondo ◽

Keisuke Shiose ◽

Yosuke Yamada ◽

Takuya Osawa ◽

Hiroyuki Sagayama ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Fat Free Mass ◽

Dilution Method ◽

Rapid Weight Loss ◽

Body Composition Assessment ◽

Air Displacement Plethysmography ◽

Time Points ◽

Thoracic Gas Volume ◽

Gas Volume

We investigated the effect of rapid weight loss (RWL) and weight regain (WR) on thoracic gas volume (VTG) and body composition assessment using air displacement plethysmography (ADP) in male wrestlers. Eight male elite collegiate wrestlers completed a RWL regimen (6% of body mass) over a 53-h period, which was followed by a 13-h WR period. ADP was used at three time points (baseline (T1), post-RWL (T2) and post-WR (T3)) according to the manufacturer’s testing recommendations. The total body water and bone mineral content were estimated using the stable isotope dilution method and dual energy X-ray absorptiometry, respectively, at the same time points. Body composition was assessed with two-component (2C) or four-component (4C) models using either the measured VTG (mVTG) or predicted VTG (pVTG). Measured VTG increased from T1 to T2 (0.36 ± 0.31 L, p < 0.05) and decreased from T2 to T3 (−0.29 ± 0.15 L, p < 0.01). However, the changes in fat mass and fat free mass, which were calculated by both 2C and 4C models, were not significantly different when compared between calculations using mVTG and those using pVTG. Our results indicate that VTG significantly changes during RWL and WR, but both measured and predicted VTG can be used to assess changes in body composition during RWL and WR.

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Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

Obesity Surgery ◽

10.1007/s11695-021-05388-9 ◽

2021 ◽

Author(s):

Marleen M. Romeijn ◽

Marlies Bongers ◽

Daniëlle D.B. Holthuijsen ◽

Loes Janssen ◽

François M.H. van Dielen ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Employment Status ◽

Weight Regain ◽

Weight Loss Outcomes ◽

Working Status ◽

Successful Weight Loss ◽

Patients Experience ◽

The Impact

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract

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Impact of Bariatric Surgery on the Long-term Disease Course of Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz236 ◽

2019 ◽

Vol 26 (7) ◽

pp. 1089-1097 ◽

Cited By ~ 2

Author(s):

Manuel B Braga Neto ◽

Martin H Gregory ◽

Guilherme P Ramos ◽

Fateh Bazerbachi ◽

David H Bruining ◽

...

Keyword(s):

Bariatric Surgery ◽

Inflammatory Bowel Disease ◽

Weight Loss ◽

Bowel Disease ◽

Inflammatory Bowel ◽

A Prospective Study ◽

Prospective Study Design ◽

The Impact

Abstract Background An association between inflammatory bowel disease (IBD) and obesity has been observed. Little is known about the effect of weight loss on IBD course. Our aim was to determine the impact of bariatric surgery on long-term clinical course of obese patients with IBD, either Crohn's disease (CD) or ulcerative colitis (UC). Methods Patients with IBD who underwent bariatric surgery subsequent to IBD diagnosis were identified from 2 tertiary IBD centers. Complications after bariatric surgery were recorded. Patients were matched 1:1 for age, sex, IBD subtype, phenotype, and location to patients with IBD who did not undergo bariatric surgery. Controls started follow-up at a time point in their disease similar to the disease duration in the matched case at the time of bariatric surgery. Inflammatory bowel disease medication usage and disease-related complications (need for corticosteroids, hospitalizations, and surgeries) among cases and controls were compared. Results Forty-seven patients met inclusion criteria. Appropriate matches were found for 25 cases. Median follow-up among cases (after bariatric surgery) and controls was 7.69 and 7.89 years, respectively. Median decrease in body mass index after bariatric surgery was 12.2. Rescue corticosteroid usage and IBD-related surgeries were numerically less common in cases than controls (24% vs 52%; odds ratio [OR], 0.36; 95% confidence interval [CI], 0.08–1.23; 12% vs 28%; OR, 0.2; 95% CI, 0.004–1.79). Two cases and 1 control were able to discontinue biologics during follow-up. Conclusions Inflammatory bowel disease patients with weight loss after bariatric surgery had fewer IBD-related complications compared with matched controls. This observation requires validation in a prospective study design.

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Evaluation of Resting Energy Expenditure in Subjects with Severe Obesity and Its Evolution After Bariatric Surgery

Obesity Surgery ◽

10.1007/s11695-021-05578-5 ◽

2021 ◽

Author(s):

Enzamaria Fidilio ◽

Marta Comas ◽

Miguel Giribés ◽

Guillermo Cárdenas ◽

Ramón Vilallonga ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Energy Expenditure ◽

Severe Obesity ◽

Resting Energy Expenditure ◽

Successful Weight Loss ◽

The Impact ◽

The Relationship ◽

Resting Energy

Abstract Purpose One major determinant of weight loss is resting energy expenditure (REE). However, data regarding REE is scarce in patients with severe obesity (SO)—BMI>50kg/m2. Most studies used equation in order to estimate REE and not indirect calorimetry (IC) (gold standard). Additionally, there is no reliable data on the impact of bariatric surgery (BS) on REE. Objectives (a) To evaluate the REE in patients with SO; (b) to compare REE measured by IC (mREE) to that calculated by Mifflin St-Jeor equation (eREE); (c) to evaluate the impact of BS on REE and the relationship with evolution post-BS. Material and Methods Single-center observational study including consecutive patients with SO between January 2010 and December 2015, candidates for BS. mREE was determined at baseline, and 1 and 12 months post-BS by IC, using a Vmax metabolic monitor. Results Thirty-nine patients were included: mean age 46.5±11.77 years, 64.1%women. Preoperative mREE was 2320.38±750.81 kcal/day. One month post-BS, the mREE significantly decreased (1537.6 ± 117.46 kcal/day, p = 0.023) and remained unchanged at 12 months (1526.00 ± 123.35 kcal/day; p =0.682). Reduction in mREE after the BS was a predictor of reaching successful weight loss (nadir) and weight regain (5 years follow-up) (AUCROC of 0.841 (95%CI [0.655–0.909], p=0.032) and AUCROC of 0.855 (95% CI [0.639–0.901]), p= 0.027, respectively). eREE was not valid to identify these changes. Conclusion In patients with SO, a significant reduction of mREE occurs 1 month post-BS, unchanged at 12 months, representing the major conditioning of successful weight loss and maintenance post-BS. Graphical abstract

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