Influence of Energy Balance on the Rate of Weight Loss Throughout One Year of Roux-en-Y Gastric Bypass: a Doubly Labeled Water Study

Author(s)

Ravelli, Michele Novaes ^{[1, 2]} ; Schoeller, Dale A. ^[3] ; Crisp, Alex Harley ^[1] ; Shriver, Timothy ^[3] ; Ferriolli, Eduardo ^[4] ; Ducatti, Carlos ^[5] ; Marques de Oliveira, Maria Rita ^[6]

Affiliation

^[1] Sao Paulo State Univ Unesp, Sch Pharmaceut Sci, Rodovia Araraquara Jau, Km 01, BR-14800903 Araraquara, SP - Brazil

^[2] Univ Wisconsin, Dept Neurol, 1685 Highland Ave, Med Fdn Centennial Bldg, Madison, WI 53705 - USA

^[3] Univ Wisconsin, Biotechnol Ctr, 425 Henry Mall St, Madison, WI 53706 - USA

^[4] Univ Sao Paulo, Ribeirao Preto Med Sch, Ave Bandeirantes, 3900 Bairro Monte Alegre, BR-14049900 Ribeirao Preto, SP - Brazil

^[5] Sao Paulo State Univ UNESP, Stable Isotope Ctr, Biosci Inst, Rua Prof Dr Antonio Celso Wagner Zanin, BR-18618689 Botucatu, SP - Brazil

^[6] Sao Paulo State Univ UNESP, Inst Biosci, Educ Dept, Rua Prof Dr Antonio Celso Wagner Zanin, BR-18618689 Botucatu, SP - Brazil

• Document type: Journal article
• Source: OBESITY SURGERY; v. 29, n. 10, p. 3299-3308, OCT 2019.
• Web of Science Citations: 0

Abstract

Objective To investigate the influence of changes in energy balance and body composition on the rate of weight loss throughout 1 year of Roux-en-Y gastric bypass. Methods Variables were collected pre-, 6, and 12 months (M) post-surgery from 18 women (BMI >= 40 and <= 50 kg m(-2), 20 to 45 years). Total energy expenditure (TEEm), fat-free mass (FFM), and fat mass (FM) were measured by doubly labeled water. Self-reported energy intake (EIsr) was obtained from three non-consecutive food diaries. Metabolic adaptation was assessed via deviations from TEE predictive equation, and the calculated energy intake (EIc) via the sum of TEE and change in body stores. Results BMI significantly decreased (mean SD) from 452 kg m(-2) to 32 +/- 3 kg m(-2) at 6 M, and to 30 +/- 3 kg m(-2) at 12 M after surgery. The TEEm reduced significantly at both time points when compared with pre-surgery (6 M: -612 +/- 317 kcal day(-1); 12 M: -447 +/- 516 kcal day(-1)). At 6 M, a metabolic adaptation was observed and the energy balance was -1151 +/- 195 kcal day(-1), while at 12 M it was -332 +/- 158 kcal day(-1). Changes in the values of TEEm were associated with changes in body weight at 12 M post-surgery. A significant underreporting was observed for EIsr (1057 +/- 385 kcal day(-1)) vs. EIc (2083 +/- 309 kcal day(-1)) at 12 M post-operative. Conclusion The higher rate of weight loss at 6 M post-surgery was a response to energy imbalance, which was caused by high restriction in energy intake even with the presence of metabolic adaptation at this time. The EIsr was not sufficiently accurate to assess the energy consumption of this population. (AU)

• FAPESP's process: 13/03998-2 - Energy metabolism, body composition and food intake in bariatric surgery.
• Grantee: Michele Novaes Ravelli
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 16/02306-8 - Energy metabolism, body composition and food intake in bariatric surgery
• Grantee: Michele Novaes Ravelli
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 13/04420-4 - Assessment of the influence of metabolic and genetic factors on energy homeostasis after bariatric surgery
• Grantee: Maria Rita Marques de Oliveira
• Support Opportunities: Regular Research Grants