Body Composition Changes in Adolescents Who Underwent Bariatric Surgery: A Systematic Review and Meta-analysis.

PURPOSE OF REVIEW: The purpose of this review and meta-analysis is to characterize the changes in body composition of children and adolescents who underwent bariatric surgery and identify possible negative effects of performing this procedure during pediatric ages. RECENT FINDINGS: Bariatric surgery in children and adolescents is an emerging strategy to promote higher and faster body weight and fat mass losses. However, possible negative effects usually observed in surgical patients' muscle-skeletal system raise a major concern perform this intervention during growth. Despite these possible issues, most experimental studies and reviews analyze bariatric surgery's effectiveness only by assessing anthropometric outcomes such as body weight and BMI, disregarding the short- and long-term impact of bariatric surgery on all body composition outcomes. Bariatric surgery is effective to reduce fat mass in adolescents, as well as body weight, waist circumference, and BMI. Significant reduction in lean mass and fat-free mass is also observed. Bone mass seems not to be impaired. All outcomes reduction were observed only in the first 12 months after surgery. Sensitivity analysis suggests possible sex and type of surgery-related differences, favoring a higher fat mass, body weight, and BMI losses in boys and in patients who underwent RYGB.

Analysis of Walking Economy after Sleeve Gastrectomy in Patients with Severe Obesity.

BACKGROUND: Obesity is associated with a higher energy cost of walking which affects activities of daily living. Bariatric surgery with sleeve gastrectomy (SG) has beneficial effects on weight loss and comorbidities. PURPOSE: The aim of this study was to analyze the impact of SG on walking economy in subjects with severe obesity. METHODS: This observational cohort study included all patients with morbid obesity who were considered suitable candidates for SG between June 2017 and June 2019. Each patient underwent an incremental cardiopulmonary exercise test on a treadmill (modified Bruce protocol) one month before and six months after SG. Data on the energy cost of walking were recorded during three protocol stages (stage 0-slow flat walking: speed 2.7 km/h, slope 0%; stage ½-slow uphill walking: speed 2.7 km/h, slope 5%; stage 1-fast uphill walking: speed 4.0 km/h, slope 8%). RESULTS: 139 patients with morbid obesity (78% women; age 44.1 ± 10.7 years; BMI 42.5 ± 4.7 kg/m2) were included in the study. At six months post-SG, patients presented with a significantly decreased body weight (-30.5 ± 17.2 kg; p < 0.05), leading to an average BMI of 31.6 ± 4.2 kg/m2. The net energy cost of walking (measured in J/m and J/kg/m) of the subjects was lower compared to pre-SG at all three protocol stages. This improvement was also confirmed when the subjects were grouped by gender and obesity classes. CONCLUSION: After a significant weight loss induced by SG, regardless of the severity of obesity and gender, patients exhibited a lower energy expenditure and an improved walking economy. These changes make it easier to perform daily routines and may facilitate an increase in physical activity.