Preservation of Fat-free Mass after Bariatric Surgery: A Comparison of Malabsorptive and Restrictive Procedures

Abstract

The Roux-en-Y gastric bypass (RYGB) has been shown to cause significant weight loss. However, fat-free mass (FFM) is often lost with this rapid weight change. It is suggested that the loss of FFM is minimized with restrictive-only procedures, such as the vertical sleeve gastrectomy (VSG), when compared with malabsorptive surgery. The purpose of the study was to determine the difference in the postoperative loss of FFM between RYBG and VSG patients. We reviewed all patients who underwent RYGB or VSG between May 2012 and January 2013. Patients were evaluated one month before their procedure and 12 months after for comparison of results. Preoperative and postoperative body analysis data were procured using a body composition analysis device. Within the study period, 33 patients underwent a RYGB procedure and 20 patients a VSG. After 12 months, RYGB patients had an average increase of 38.15 per cent in their proportion of FFM, whereas VSG patients had an average FFM increase of 22.09 per cent, a statically significant difference ( P = 0.004). The RYGB helps preserve overall FFM as compared with the VSG. These findings are unexpected because malabsorptive procedures require increased protein intake, resulting in a stronger likelihood of inadequate protein intake, which may lead to protein malnutrition.

Fat‐Free Mass and Skeletal Muscle Mass Five Years After Bariatric Surgery

“…Early observations by Forbes ( 24 ) point to a close linkage between body weight and FFM, such that some FFM loss is expected during body weight loss. Indeed, results from numerous studies have shown FFM losses of similar magnitude or greater than this study during rapid weight loss in the first 1–2 years after RYGB ( 7 , 25 , 26 , 27 , 28 , 29 , 30 ), SLEEVE ( 7 , 25 , 28 , 29 ), and BAND ( 7 , 26 , 27 , 31 , 32 , 33 ) procedures. The rate and amount of FFM lost during these initial post-operative years may vary by surgical procedure, extent of weight loss, and possibly assessment method.…”

Fat-Free Mass and Skeletal Muscle Mass Gain Are Associated with Diabetes Remission after Laparoscopic Sleeve Gastrectomy in Males but Not in Females

“…The recent finding showed that SM protected metabolically healthy boys with obesity from cardiometabolic risks, but not girls [ 13 ]. Hence, the association of FFM and SM that account for metabolic regulation [ 14 ] with T2D remission post-LSG requires an understanding of sex-manner. Therefore, this study investigated the effect of FFM and SM on diabetes remission stratified by sex differences after 12 months of LSG.…”

Efeitos Do Método Pilates Na Composição Corporal E Antropometria No Pós-Operatório Tardio De Cirurgia Bariátrica: Relato De Caso.

“…Assim sendo, a CB pode alcançar resultados promissores, reduzindo maisda metade do excesso de peso, com benefícios são conservados em longo prazo pela melhora nas variáveis metabólicas com implicação positiva no metabolismo dos lipídeos e carboidratos, reduzindo, assim, a resistência a insulina e também, colaborando para o controle do diabetes tipo 2 e hiperlipidemias (12) .…”

“…Ademais, houve decréscimo desta variável após a aplicação do protocolo. Em relação ao pequeno aumento da massa magra, supõe-se que a paciente realizara uma ingesta adequada de proteínas, fato este que pode evitar a desnutrição protéica que é incidente no póscirúrgico de CB (12) .…”