Body mass index patterns following dysvascular lower extremity amputation

Abstract

• People undergoing lower-extremity amputation have high rates of overweight and obesity and continue to gain weight in the year following amputation. • Objective assessment of body mass index (both with and without a prosthetic device) and waist circumference would help future research efforts. • Targeting weight loss post-amputation could improve the health of people with lower-extremity amputations.

Lower-limb amputation and body weight changes in men

“…In that study, mean weight gain in 87 people with a dysvascular major amputation was 6 lb over 12 mo, which is somewhat less than that observed in this study and may reflect different inclusion criteria [11]. Nevertheless, the two studies are in agreement regarding the direction of weight change.…”

“…We are aware of only one other study that investigated weight change following amputation [11]. In that study, mean weight gain in 87 people with a dysvascular major amputation was 6 lb over 12 mo, which is somewhat less than that observed in this study and may reflect different inclusion criteria [11].…”

“…Comorbid depression, which is highly prevalent in this population [18][19], may also contribute to inactivity and overeating. Our prior work suggested that high BMI and weight gain are associated with impaired mobility [11], resulting in lower levels of physical activity. The inverse association between preamputation BMI and relative weight gain may be because those with a lower BMI preamputation may have been more active and decreased their activity more postamputation than those with a higher BMI, though future studies are needed to replicate and better understand this finding.…”

“…To our knowledge, only one longitudinal study has assessed weight change following LLA. This study included 87 individuals who underwent a dysvascular LLA [11]. Compared with 6 wk after amputation, body mass index (BMI) had increased by 1.4 kg/m 2 on average 12 mo postamputation, or about 4.5 kg (10 lb) for a person with a starting weight of 100 kg (220 lb) and height of 1.8 m (5 ft 10 in.…”

Weight loss intention, dietary behaviors, and barriers to dietary change in veterans with lower extremity amputations

“…We calculated a limb loss-adjusted body mass index (LLA-BMI, kg/ m 2 ) as a proxy for body fat employing previously published methods that attempt to account for the weight difference due to the limb loss. 9,24,25 Briefly, this method assumes that limb weight is proportional to total body weight, and assigns a standard percentage of body weight loss for a given amputation level (e.g., 5% for a unilateral transtibial amputation). This weight is then added to the self-reported weight.…”