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Factors influencing energy intake and body weight loss after gastric bypass

European Journal of Clinical Nutrition volume 56, pages 551–556 (2002)Cite this article

Abstract

Objective: The gastric bypass-induced quantitative and qualitative modifications of energy intake (En In, kcal/day) and their impact on body weight (bw) loss were evaluated. The factors influencing energy intake and body weight loss were also investigated.

Design: Longitudinal study.

Setting: University Hospital of Geneva.

Subjects: Fifty obese women undergoing a Roux-en-Y gastric bypass.

Results: The reduction of EnIn was significantly related to bw loss expressed either in kg or as percentage correction of excess bw (P<0.01 for both), whereas the post-operative modifications of diet composition did not play a role. Age and initial bw significantly influenced bw loss (P<0.0001 and P<0.001, respectively), as shown by multiple regression analysis. Patients were divided into four sub-groups according to their age (under or over 35 y) and initial bw (under or over 120 kg). ANOVA showed that under 35-y-old subjects reduced their EnIn significantly more than their older counterparts having similar bw (P<0.02 and P<0.05); consequently, bw loss, expressed in kg, was significantly (P<0.0001 and P<0.0005) larger in younger patients. Subjects with an initial bw over 120 kg lost significantly (P<0.001 and P<0.02) more weight as compared to patients with a smaller degree of obesity (under 120 kg) and similar age.

Conclusions: Gastric bypass-induced body weight loss is mainly due to the reduction of EnIn, whereas the qualitative modifications of the diet do not play a role. Younger subjects have a greater capacity to reduce EnIn and, therefore, lose more weight. Pre-operative high degree of obesity leads to a larger weight reduction, probably because of a greater energy deficit.

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References

  • Alford BB, Blankenship AC, Hagen RD . 1990 The effects of variation in carbohydrate, protein and fat content of the diet upon weight loss J. Am. Diet. Assoc. 90: 534–540

    CAS  PubMed  Google Scholar 

  • Blaak EE . 2000 Adrenergically stimulated fat utilization and ageing Ann. Med. 32: 380–382

    Article  CAS  Google Scholar 

  • Bloomston M, Zervos EE, Camps MA, Goode SE, Rosemurgy AS . 1997 Outcome following bariatric surgery in super versus morbidly obese patients: does weight matter? Obes. Surg. 7: 414–419

    Article  CAS  Google Scholar 

  • Brolin RE, Robertson LB, Kenler HA, Cody RP . 1994 Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass Ann. Surg. 220: 782–790

    Article  CAS  Google Scholar 

  • Dixon JB, Dixon ME, O'Brien PE . 2001 Pre-operative predictors of weight loss at one year after lap-band surgery Obes. Surg. 11: 200–207

    Article  CAS  Google Scholar 

  • Donnelly JE, Jacobsen DJ, Whatley JE . 1994 Influence of degree of obesity on loss of fat-free mass during very-low-energy diets Am. J. Clin. Nutr. 60: 874–878

    Article  CAS  Google Scholar 

  • Dwyer JT . 1992 Treatment of obesity In Conventional Programs and Fat Diets in Obesity ed. P Björntorp & NN Brodoff, Vol 57: pp 662–676 Philadelphia, PA: JB Lippincott

    Google Scholar 

  • Ferrannini E . 1988 The theoretical basis of indirect calorimetry: a review Metabolism 37: 287–301

    Article  CAS  Google Scholar 

  • Golay A, Allaz AF, Morel Y, de Tonnac N, Tankova S, Reaven G . 1996 Similar weight loss with low- or high-carbohydrate diets Am. J. Clin. Nutr. 63: 174–178

    Article  CAS  Google Scholar 

  • Hall JC, Watts JM, O'Brien PE, Dustan RE, Walsh JF, Slavotinek AH, Elmslie RG . 1990 Gastric surgery for morbid obesity: the Adelaide study Ann. Surg. 211: 419–427

    Article  CAS  Google Scholar 

  • Howatt MP, Mohan R, Champagne C, Monlezun C, Wozniak P, Bray GA . 1994 Validity and reliability of reported dietary intake data J. Am. Diet. Assoc. 94: 169–173

    Article  Google Scholar 

  • Jéquier E, Felber JP . 1987 Indirect calorimetry Baillière's Clin. Endocrinol. Metab. 1: 911–935

    Article  Google Scholar 

  • Kenler HA, Brolin RE, Cody RP . 1990 Changes in eating behaviour after horizontal gastroplasty and Roux-en-Y gastric bypass Am. J. Clin. Nutr. 52: 87–92

    Article  CAS  Google Scholar 

  • Klesges RC, Eck LH, Ray JW . 1995 Who underreports dietary intake in a dietary recall? Evidence from the Second National Health and Nutrition Examination Survey J. Consult. Clin. Psychol. 63: 438–444

    Article  CAS  Google Scholar 

  • Kral JC . 1992 Surgical treatment of obesity In Obesity ed. P Björntorp & BN Bronoff pp 731–741 Philadelphia, PA: JB Lipincott

    Google Scholar 

  • Kretsch MJ, Fong AK, Green MW . 1999 Behavioural and body size correlates of energy intake underreporting by obese and normal-weight women J. Am. Diet. Assoc. 99: 300–306

    Article  CAS  Google Scholar 

  • Lindroos AK, Lissner L, Sjöstrom L . 1996 Weight change in relation to intake of sugar and sweet foods before and after weight reducing gastric surgery Int. J. Obes. Relat. Metab. Disord. 20: 634–643

    CAS  PubMed  Google Scholar 

  • Lissner L, Lindroos AK, Sjöström L . 1998 Swedish obese subjects (SOS): an obesity intervention study with nutritional perspective Eur. J. Clin. Nutr. 52: 316–322

    Article  CAS  Google Scholar 

  • Lusk G . 1924 Animal calorimetry: analysis of the oxidation of mixtures of carbohydrates and fat J. Biol. Chem. 59: 41–42

    CAS  Google Scholar 

  • Näslund I, Wickbom G, Christofferson E, Agren G . 1986 A prospective randomized comparison of gastric bypass and gastroplasty: complications and early results Acta. Chir. Scand. 152: 681–689

    PubMed  Google Scholar 

  • Näslund I, Järnmark I, Andersson H . 1988 Dietary intake before and after gastric bypass and gastroplasty for morbid obesity Int. J. Obes. 12: 503–513

    PubMed  Google Scholar 

  • Nickals BJ, Rogus EM, Goldberg AP . 1997 Exercise blunts declines in lipolysis and fat oxidation after dietary-induced weight loss in obese older women Am. J. Physiol. Endocrinol. Metab. 273: E149–E155

    Article  Google Scholar 

  • Pasquali R, Casimiri F, Melchionda N . 1987 Protein metabolism in obese patients during very low-calorie mixed diets containing different amounts of proteins and carbohydrates Metabolism 36: 1141–1148

    Article  CAS  Google Scholar 

  • Pories WJ, Flickinger EG, Meehleim D, Van Rij AM, Thomas FT . 1982 The effectiveness of gastric bypass over gastric partition in morbid obesity Ann. Surg. 196: 398–399

    Article  Google Scholar 

  • Rabast U, Vomberger KH, Ehl M . 1981 Loss of weight, sodium and water in obese persons consuming a high or low carbohydrate diet Ann. Nutr. Metab. 25: 342–349

    Article  Google Scholar 

  • Sugerman HJ, Starkey JV, Birkenhauer RA . 1987 A randomized prospective trial of gastric bypass vs vertical banded gastroplasty Roux-en-Y gastric bypass and their effects on sweet vs non-sweet eaters Ann. Surg. 205: 613–624

    Article  CAS  Google Scholar 

  • Sugerman HJ, Londrey GL, Kellum JM, Wolf L, Liszka T, Engle KM, Birkenhauer RA, Starkey JV . 1989 Weight loss with vertical banded gastroplasty and Roux-en-Y gastric bypass for morbid obesity with selective vs random assignement Am. J. Surg. 157: 93–102

    Article  CAS  Google Scholar 

  • Talieh J, Kirgan D, Fisher BL . 1997 Gastric bypass for morbid obesity: a standard surgical technique by consensus Obes. Surg. 7: 518–520

    Article  Google Scholar 

  • Toth MJ, Tcherof A . 2000 Lipid metabolism in elderly Eur. J. Clin. Nutr. 54: (Suppl 3): S121–S125

    Article  CAS  Google Scholar 

  • Zhang J, Temme EH, Sasaki S, Kesteloot H . 2000 Under- and overreporting of energy intake using urinary cations as biomarkers: relation to body mass index Am. J. Epidemiol. 152: 453–462

    Article  CAS  Google Scholar 

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Acknowledgements

This study was partially supported by the Swiss National Funds for Scientifical Research, grant no. 32-61339.00 and by a grant from the Ernst and Lucie Schmidheiny Foundation.

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Author notes

  1. E Bobbioni-Harsch: Guarantor: E Bobbioni-Harsch.

  2. E Bobbioni-Harsch, O Huber, Ph Morel, G Chassot, T Lehmann, M Volery, E Chliamovitch, C Muggler and A Golay: Contributors: O Huber, Ph Morel, G Chassor, T Lehmann, M Volery, E Chliamovitch, C Muggler and A Golay.

Authors and Affiliations

  1. Division of Therapeutic Education for Chronic Diseases, Geneva University Hospital, Geneva, Switzerland

    E Bobbioni-Harsch, T Lehmann & A Golay

  2. Clinic of Digestive Surgery, Geneva University Hospital, Geneva Medical School, Geneva, Switzerland

    O Huber, Ph Morel, G Chassot, M Volery, E Chliamovitch & C Muggler

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  1. E Bobbioni-Harsch
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Bobbioni-Harsch, E., Huber, O., Morel, P. et al. Factors influencing energy intake and body weight loss after gastric bypass. Eur J Clin Nutr 56, 551–556 (2002). https://doi.org/10.1038/sj.ejcn.1601357

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