Comparison of nutritional consequences of conventional therapy of obesity, adjustable gastric banding, and gastric bypass.
BACKGROUND
Roux-en-Y gastric bypass (RYGBP) is more efficient than adjustable gastric banding (AGB) in weight loss and relieving co-morbidities, but nutritional complications of each surgical procedure have been poorly evaluated.


METHODS
A cross-sectional study was performed to compare nutritional parameters in 201 consecutive obese patients, who had been treated either by conventional behavioral and dietary therapy (CT, n=110) or by bariatric surgery, including 51 AGB and 40 RYGBP.


RESULTS
BMI was similar after AGB (36.6 +/- 5.3 kg/m2) and RYGBP (35.4 +/- 6.3 kg/m2), but patients in the RYGBP group had lost more weight and had less metabolic disturbances than those in the AGB group. On the other hand, the prevalence of nutritional deficits was significantly higher in the RYGBP group than in the 2 other groups (P<0.01), whereas the AGB group did not differ from CT. Particularly, the RYGBP group presented an unexpected high frequency of deficiencies in fat-soluble vitamins. Moreover, vitamin B12, hemoglobin, plasma prealbumin and creatinine concentrations were low in the RYGBP group.


CONCLUSIONS
RYGBP is more efficient than AGB in correcting obesity, but this operation is associated with a higher frequency of nutritional deficits that should be carefully monitored.
Ledoux
Séverine
S
Explorations fonctionnelles, Hôpital Louis Mourier (AP-HP), 178 rue des Renouillers, 92700 Colombes, France. severine.ledoux@lmr.aphp.fr
Msika
Simon
S
Moussa
Fathi
F
Larger
Etienne
E
Boudou
Philippe
P
Salomon
Laurence
L
Roy
Carine
C
Clerici
Christine
C
D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D015391:Gastroplasty / Q000009:adverse effects; D006801:Humans; D008297:Male; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery / Q000628:therapy*