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Obesity Surgery
Published in: Obesity Surgery 1/2020

01-01-2020 | Bariatric Surgery | Original Contributions

Body Composition Changes Following a Very-Low-Calorie Pre-Operative Diet in Patients Undergoing Bariatric Surgery

Authors: Jonathan Sivakumar, Lynn Chong, Salena Ward, Tom R Sutherland, Matthew Read, Michael W Hii

Published in: Obesity Surgery | Issue 1/2020

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Abstract

Background

Fatty liver in obese patients increases the technical difficulty of bariatric surgery. Pre-operative weight loss with a very-low-calorie diet (VLCD) is commonly used to facilitate surgery. Few studies have quantified the systemic effect of rapid pre-operative weight loss on body composition. The objective of this study is to evaluate body composition changes in bariatric surgery patients undergoing a VLCD.

Methods

Body composition assessments were performed between August 2017 and January 2019 using dual-energy X-ray absorptiometry immediately before and after a 2-week VLCD at St Vincent’s Hospital Melbourne. Data collected prospectively pre- and post-VLCD included total body weight, excess body weight, body mass index (BMI), lean body mass (LBM), fat mass (FM) and bone mineral content (BMC). The pre- and post-operative results were compared.

Results

Forty-four patients completed both the 2-week VLCD and body composition assessments. Following a 2-week VLCD, patients lost a mean of 4.5 kg (range − 0.3 to 9.5) in a total body weight and 8.8% (range − 0.9 to 17.1) of excess body weight, with a mean reduction in body mass index of 1.6 kg/m2 (range − 0.2 to 3.1). Loss of LBM was 2.8 kg and was significantly greater than loss of FM, 1.7 kg (p < 0.05). BMC changes were insignificant.

Conclusion

A VLCD is an effective tool for pre-operative weight reduction. In this cohort, a large amount of the total weight loss was attributed to a loss of lean body mass. The impact of significant lean body mass loss and its relationship to short- and long-term health outcomes warrants further assessment.
Appendix
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Metadata
Title
Body Composition Changes Following a Very-Low-Calorie Pre-Operative Diet in Patients Undergoing Bariatric Surgery
Authors
Jonathan Sivakumar
Lynn Chong
Salena Ward
Tom R Sutherland
Matthew Read
Michael W Hii
Publication date
01-01-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04174-y

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