Objetivo: Avaliar a evolução e a classificação do peso corporal em relação aos resultados da cirurgia bariátrica em mulheres submetidas ao procedimento cirúrgico há mais de dois anos. Sujeitos e método: Foram avaliadas 141 mulheres submetidas à derivação gástrica em Y de Roux (DGYR) com anel de contenção. As participantes foram divididas de acordo com o tempo de pós-operatório e conforme o percentual da perda do excesso de peso (%PEP): < 50; 50 ┤ 75; e, ≥ 75. Resultados: As mulheres do grupo com %PEP ≤ 50 (15,6%) se mantiveram obesas, enquanto aquelas que apresentaram %PEP ≥ 75 (36,2%) situaram-se entre a eutrofia e pré-obesidade e tiveram menor índice de recuperação tardia de peso em relação aos demais grupos. Conclusão: A evolução de peso após dois ou mais anos da cirurgia mostrou sua esperada redução com variados graus de resposta, apontando a necessidade de monitoramento, investigação e intervenção para obtenção dos resultados esperados. Arq Bras Endocrinol Metab. 2010;54(3):303-10 Descritores Obesidade mórbida; cirurgia bariátrica; peso corporal; perda de peso ABSTRACT Objective: The objective of this study was to assess the evolution and classification of body weight in relation to the results of bariatric surgery in women who underwent the procedure more than two years ago. Subjects and method: A total of 141 women underwent banded Roux-en-Y gastric bypass (RYGB). The participants were divided according to the time elapsed since surgery and the percentage of excess weight lost (%EWL): < 50; 50 ┤ 75; and ≥ 75. Results: The women in the group with %EWL ≤ 50 (15.6%) remained obese, while those with %EWL ≥ 75 (36.2%) ranged from normal to pre-obese and presented lower late weight gain than the women in the other groups. Conclusion: Weight evolution two or more years after surgery showed the expected reductions, with some individuals responding better to surgery than others. This shows that it is necessary to monitor, investigate and intervene to obtain the desired results. Arq Bras Endocrinol Metab. 2010;54(3):303-10 Keywords Morbid obesity; bariatric surgery; body weight; weight loss INTRODUÇÃO A obesidade tornou-se epidemia e problema de saúde pública em todo o mundo, sem distinção de sexo e idade (1-3). As consequências da obesidade no indivíduo, principalmente em seu grau mais avançado, são evidentes, como a redução na expectativa e na qualidade de vida, os problemas psicossociais e a incidência de doen ças concomitantes (4-6).Em situação grave, a cirurgia bariátrica tem configurado como o único tratamento para alcançar perda
Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50┤75; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL<50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake.
RMR did not interfere in underreporting estimates. However, PAL variations were responsible for significant differences in cutoff point. Thus, PAL should be considered when estimating underreporting, and even though the individual approach is less sensitive than the group approach, it may be a useful tool for clinical practice.
The anatomical and physiological changes of the gastrointestinal tract after Roux-en-Y gastric bypass lead to changes in dietary patterns and their effects are still little known. Hence, the objective of this work was to characterize the prevalence, the associated factors and the list of food aversions with the effect of surgery on the body weight of women in the first two years after Roux-en-Y gastric bypass. A total of 141 women were studied. Their food aversions were assessed with a short food frequency questionnaire (FFQ-S) containing 26 items before and 6, 12 and 24 months after surgery. The FFQ-S was filled out during individual interviews and referenced in the medical records. The association between total aversion score and body weight variables and general characteristics of the group was analyzed. Variation of food aversions over time was assessed for 26 foods individually and grouped. Of all the studied variables, a weak but significant negative correlation (rs = -0.1944; p = 0.0208) was found between total aversion score and shorter postoperative period and a weak but significant positive correlation was found between total aversion score and percentage of weight regained (rs = -0.1759; p = 0.0369). Food aversions were more common in the first six months after surgery, especially to red meats, rice, chicken, eggs, pasta, milk and others. Food aversions in the early postoperative period are associated with weight variations in the first two years after surgery and subside significantly over time, probably because of a physiological and cognitive adaptation of the individual to the surgical procedure.
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