Weight Loss and Caloric Intake after Regular and Extended Gastric Bypass.
The morbidly obese and especially the super-morbidly obese (> 225% ideal body weight) often require gastric bypass surgery as treatment for long-term remission of their obesity. The extended gastric bypass Roux-en-Y (X-GBP) procedure evolved as a result of a perceived need to increase weight loss in morbidly obese subjects beyond the limitations of the regular gastric bypass Roux-en-Y (R-GBP). We compared weight loss, caloric intake, and percentage of total caloric intake from carbohydrate, protein, and fat in eight R-GBP and eight X-GBP patients at 3, 6, 9, and 12 months following surgery. We found that R-GBP and X-GBP groups were similar in age and height, adjusting for baseline weight differences (p = 0.122). Both groups demonstrated significant weight loss overtime (p < 0.0001), with similar patterns of weight loss at each interval of nonsignificant interaction (p = 0.585). Weight loss for the two groups did not differ statistically. The X-GBP group lost 5% more weight than the R-GBP group by 12 months following surgery. The adjusted average weight loss over 12 months was 56.82 kg for X-GBP and 46.82 kg for R-GBP patients. Furthermore, the X-GBP group ingested fewer calories than the R-GBP group at 3, 6, 9, and 12 months following surgery. The X-GBP group ingested a lower percentage of calories from fat than the R-GBP group at 3, 9, and 12 months following surgery. This study depicts clinical trends in weight loss following X-GBP and R-GBP surgeries. The greater weight loss of the X-GBP group may be due to differences in total caloric intake or the lower percentage of calories ingested from fat. Other possibilities for the greater weight loss shown by the X-GBP group may include changes in malabsorption or resting energy expenditure over time following surgery.
Scruggs
DM
Department of Surgery, The University of Tennessee, Memphis, TN, 38163 USA.
Cowan
GS
Klesges
L
Defibaugh
N
Walker
R
Kuyper
B
Hiler
ML