Long-term effect of bariatric surgery on body composition in patients with morbid obesity: A systematic review and meta-analysis

Haghighat, Neda; Kazemi, Asma; Asbaghi, Omid; Jafarian, Fateme; Moeinvaziri, Nader; Hosseini, Babak; Amini, Masoud

doi:10.1016/j.clnu.2020.10.001

Cited by 26 publications

(13 citation statements)

References 50 publications

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“…Recently, a meta-analysis have indicated that bariatric surgeries might be effective for a decrease in FM and maintenance of FFM in patients with morbid obesity in over one year [49], but did not mention variations in BCM as well as in raw BIA variables; body composition was evaluated by most of papers by using Dual-Energy X-ray Absorptiometry, BIA and BOD POD [49]. In the papers selected for this review body composition was evaluated using BIA; FM decreased by 35e50 % [33,35,42] and FFM (or lean body mass or skeletal muscle mass) in most cases by about 15 % [33e35, 37,38,42], regardless of the type of surgery.…”

Section: Longitudinal Studiesmentioning

confidence: 99%

Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review

Vincenzo

Marra²,

Sacco

et al. 2021

Clinical Nutrition

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Background & aims: Bioimpedance analysis-derived phase angle (PhA), as marker of body cell mass and cell integrity, might be altered in obesity, a condition which is characterized by alterations in muscle structure and function. The aim of this systematic review was to evaluate whether and to which extent PhA varies in individuals/ patients with excess body weight focusing on: a) changes in PhA due to obesity; b) changes in PhA after bariatric interventions or training programs. Methods: According to PRISMA criteria, a systematic literature search until February 2021 using PubMed, Embase, Scopus, and Web of Science was performed. Selection criteria included studies on patients with obesity without comorbidities other than metabolic diseases. Results: A total of 278 articles were first identified. After removing duplicates and excluding studies that did not fulfil the inclusion criteria, the full text of the remaining 80 potentially relevant studies was examined to finally retrieve 11 cross-sectional and 10 longitudinal studies. Few studies have shown that PhA is lower in individuals/patients with obesity than in controls. The only study on the matter showed a decrease with age after the fourth decade of life. Four out of five studies reported consistently greater mean values in men than in women. In two studies PhA was lower in patients with severe obesity; in addition, Patients with low PhA had higher BMI and PhA was inversely correlated with fat mass. Longitudinal studies showed that PhA markedly decreased after bariatric surgery and slightly increased after training programs. Conclusions: Thus, a relatively low number of studies have evaluated PhA in individuals/patients with obesity with sometimes contradictory and preliminary results. PhA might be useful to evaluate muscle quality in individuals/patients with obesity but further studies are needed to more accurately associate this variable with changes in muscle structure and strength, as well as in metabolic functions.

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Section: Longitudinal Studiesmentioning

confidence: 99%

Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review

Vincenzo

Marra²,

Sacco

et al. 2021

Clinical Nutrition

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“…Table 1 shows a glossary of medical terms reported in the present section. Regarding the outcomes, a recent meta-analysis of adult patients estimated a fat mass (FM) loss at 12 months of 28.9 kg with RYGB, 20.81 kg with LSG, and 18.51 with gastric banding (GB) [80].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Nutritional Management in Bariatric Surgery Patients

Deledda

Pintus²,

Loviselli

et al. 2021

IJERPH

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The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often not enough to achieve weight loss goals and to maintain the results over time. Bariatric surgery (BS) includes various techniques, which favor rapid and sustained weight loss. BS is a useful and, in most cases, the best treatment in severe and complicated obesity. In addition, it has a greater benefit/risk ratio than non-surgical traditional therapies. BS can allow the obese patient to lose weight quickly compared with traditional lifestyle changes, and with a greater probability of maintaining the results. Moreover, BS promotes improvements in metabolic parameters, even diabetes remission, and in the quality of life. These changes can lead to an increase of life expectancy by over 6 years on average. The nutrition of people before and after BS must be the subject of indications from a trained staff, and patients must be followed in the subsequent years to reduce the risk of malnutrition and the associated problems. In particular, it is still debated whether it is necessary to lose weight prior to surgery, a procedure that can facilitate the surgeon’s work reducing the surgical risk, but at the same time, lengthens preparation times increasing the risks associated with concomitant pathologies. Furthermore, preventing nutritional deficiencies prior to the intervention can improve the results and reduce short- and long-term mortality.

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“…A recent meta‐analysis 19 that investigated body composition changes following bariatric surgery in non‐randomized studies found an average lean mass loss one‐year post‐RYGB of 10 kg ( P < 0.001), but despite this loss, lean mass to body mass ratio increased by almost 12%. This meta‐analysis also reported smaller absolute lean mass losses post gastric banding (7 kg) and SG (9.5 kg), with smaller increases in lean mass to body mass ratios (8.1% and 5.7%, respectively) 19 . Therefore, RYGB might lead to greater fat mass losses while preserving lean mass relative to other surgical weight loss interventions.…”

Section: Introductionmentioning

confidence: 99%

“…This meta‐analysis also reported smaller absolute lean mass losses post gastric banding (7 kg) and SG (9.5 kg), with smaller increases in lean mass to body mass ratios (8.1% and 5.7%, respectively). 19 Therefore, RYGB might lead to greater fat mass losses while preserving lean mass relative to other surgical weight loss interventions. To date, no meta‐analyses have directly compared fat and lean mass changes following different types of bariatric surgeries in randomized controlled trials (RCTs) to establish whether some lead to a more favorable body composition relative to others.…”

Section: Introductionmentioning

confidence: 99%

Body composition changes at 12 months following different surgical weight loss interventions in adults with obesity: A systematic review and meta‐analysis of randomized control trials

et al. 2022

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Summary To determine relative lean mass and fat mass changes in adults with obesity following surgical weight loss interventions, a systematic review and meta‐analysis was conducted. The Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, and Scopus were screened for eligible studies. Inclusion criteria included randomized controlled trials (RCTs) performed in populations with obesity (body mass index ≥30 kg/m2) aged over 18 years, who underwent any type of bariatric surgery and reported body composition measures via dual‐energy X‐ray absorptiometry or bio‐electrical impedance analysis. Authors conducted full text screening and determined that there were six RCTs eligible for inclusion, with data extracted at 12 months post‐surgery. Meta‐analysis revealed that, relative to gastric banding, Roux‐en‐Y gastric bypass (RYGB) led to greater total body mass loss (mean difference [MD]: −9.33 kg [95% CI: −12.10, −6.56]) and greater fat mass loss (MD: −8.86 kg [95% CI: −11.80, −5.93], but similar lean mass loss (MD: −0.55 kg [95% CI: −3.82, 2.71]. RYGB also led to similar changes in total body mass, fat mass, and lean mass compared with sleeve gastrectomy. RYGB results in greater 12‐month weight and fat loss, but similar changes in lean mass, compared with gastric banding. Further RCTs comparing body composition changes following different bariatric surgery procedures are required.

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Long-term effect of bariatric surgery on body composition in patients with morbid obesity: A systematic review and meta-analysis

Cited by 26 publications

References 50 publications

Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review

Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review

Nutritional Management in Bariatric Surgery Patients

Body composition changes at 12 months following different surgical weight loss interventions in adults with obesity: A systematic review and meta‐analysis of randomized control trials

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