Is lean body mass decreased after obesity treatment by adjustable gastric banding?
BACKGROUND
There is concern that surgically-induced weight loss in obese subjects is associated with a disproportionate decrease in lean body mass (LBM) and in skeletal muscle mass (SMM), a major constituent of LBM. To address this issue, 1) we measured total and regional body composition following gastric banding in a group of obese subjects, and 2) we compared these data to those of a non-surgical control group of similar age and body size.


METHODS
Body composition was assessed by dual-energy X-ray absorptiometry (DEXA) before and after laparoscopic adjustable silicone gastric banding (LAGB) in 32 women (after 1 year: age 43.7+/-8.4 years, BMI 36.4+/-5.9 kg/m2, mean+/-SD), and in 117 control women (age 44.5+/-7.5 years; BMI 36.7+/-5.5 kg/m2) referred for non-surgical weight management, prior to weight loss. SMM was estimated using a published equation based on LBM of the extremities (appendicular LBM).


RESULTS
1 year after LAGB, body weight loss (-23.7+/-11.6 kg, P<10(-6)) was mainly due to decreased fat mass (-21.2+/-11.2 kg, P<10(-6)), and total LBM was modestly, although significantly, decreased (-2.1+/-4.2 kg, P=0.01). Appendicular LBM (-0.7+/-2.7 kg) and total SMM (-0.9+/-3.0 kg) were not significantly modified. None of the body composition variables was significantly decreased in weight-reduced subjects compared to the control group, especially appendicular LBM and total SMM.


CONCLUSIONS
Results provide no evidence for a decrease in appendicular LBM and total SMM with weight loss following LAGB. Follow-up of these obese patients revealed a very favorable pattern of change in total and regional body composition, with preservation of muscle mass.
Coupaye
Muriel
M
Department of Nutrition, Hbtel-Dieu Hospital (AP-HP), University Pierre et Marie Curie-Paris 6, Human Nutrition Research Center (CRNH-Ile de France), Paris, France.
Bouillot
Jean-Luc
JL
Poitou
Christine
C
Schutz
Yves
Y
Basdevant
Arnaud
A
Oppert
Jean-Michel
JM
D015502:Absorptiometry, Photon; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D015431:Weight Loss