Weight regain in association with macronutrient diet composition and quality of life in women at least 5 years after bariatric surgery

ABSTRACT Bariatric surgery has been shown to be the best alternative for the control of severe obesity, with improvements in patient quality of life. However, regaining weight due to inadequate nutrition can compromise surgery results. Objective: to investigate the relationship between weight gain and food consumption and quality of life among women at least 5 years after gastric bypass procedure. Methods: Seventy-three women who had bariatric surgery >= 5 years prior were evaluated for food consumption on 3 non-consecutive days and quality of life according to the dimensions of the BAROS tool. Results: Twenty two (29.7%) regained at least 10% of their weight. The group of women with stable weight loss had significantly lower carbohydrate consumption and showed no difference in energy consumption. Self-esteem and willingness to work also had a better score in this group, which contributed to a better quality of life score. Conclusion: From a weight regain below 10% after 5 years of bariatric surgery, the perception of quality of life among women changes. There are reasons for further studies on the effects of the proportion of macronutrients on dietary energy after bariatric surgery, including variations in the surgical technique and metabolic and anatomical variables.

RESUMEN La cirugía bariátrica ha mostrado ser una de las mejores alternativas para el control de la obesidad, aportando a la mejoría en la calidad de vida del paciente. Sin embargo, recuperar peso debido a una nutrición inadecuada puede comprometer los resultados de la cirugía. Objetivo: investigar la relación entre el aumento de peso y el consumo de alimentos y la calidad de vida en mujeres al menos 5 años después del procedimiento de bypass gástrico. Métodos: 73 mujeres con al menos 5 años de cirugía bariátrica fueron evaluadas para el consumo de alimentos durante 3 días no consecutivos y la calidad de vida, según las dimensiones de la herramienta BAROS. Resultados: 22 mujeres (29,7%) recuperaron al menos el 10% de su peso. El grupo de mujeres con pérdida de peso estable tuvo un consumo de carbohidratos significativamente menor y no mostró diferencias en el consumo de energía. La autoestima y la voluntad de trabajar también tuvieron un mejor puntaje en este grupo, lo que contribuyó a un mejor puntaje de calidad de vida. Conclusión: a partir de una recuperación de peso por debajo del 10% después de 5 años de cirugía bariátrica, la percepción de la calidad de vida entre las mujeres cambia y existen razones para más estudios sobre los efectos de la proporción de macronutrientes sobre la energía alimentaria después de la cirugía bariátrica, con potencial influencia de variaciones en la técnica quirúrgica.

Correction to: Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

The name of author Michele Novaes Ravelli was misspelled in the original article - it is correct here.

Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

INTRODUCTION: Bariatric surgery has a significant influence on body composition (BC), which should be monitored. However, there is a need to recommend low-cost practical methods, with good estimation of BC for class III obese and/or bariatric patients. OBJECTIVE: The aim of this study was to determine accuracy and agreement between BC assessed by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as reference method. MATERIAL AND METHODS: Twenty class III obese women (age 29.3 ± 5.1 years; body mass index 44.8 ± 2.4 kg/m2) underwent Roux-en-Y gastric bypass surgery. BC (fat mass [FM], fat-free mass [FFM], and total body water [TBW]) was assessed by InBody 230 and DLW in the following periods: before and 6 and 12 months after surgery. Accuracy between the methods was evaluated by the bias and root mean square error. Pearson's correlation, concordance correlation coefficient (CCC), and Bland-Altman method were used to evaluate agreement between the methods. RESULTS: Correlations were significant (p < 0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95), FFM (r = 0.73-0.90, CCC = 0.68-0.80), and TBW (r = 0.76-0.91, CCC = 0.72-0.81) before and after bariatric surgery. In addition, no significant bias was observed between DSM-BIA and DLW for FM (mean error [ME] = - 1.40 to 0.06 kg), FFM (ME = 0.91-1.86 kg), and TBW (ME = 0.71-1.24 kg) measurements. CONCLUSION: The DSM-BIA was able to estimate the BC of class III obese women submitted to bariatric surgery with values consistent with those of the DLW method.