title: Laparoscopic sleeve gastrectomy compared to a multidisciplinary weight loss program for obesity--effects on body composition and protein status.
abstract: BACKGROUND
  Optimal obesity therapy is a matter of debate. Besides weight reduction, other criteria such as safety and nutritional status are of relevance. Therefore, we compared a favored surgical intervention with the most effective conservative treatment regarding anthropometry and nutritional status.
  
  
  METHODS
  Fifty-four obese patients were included who underwent laparoscopic sleeve gastrectomy (LSG, n = 27) or a 52-week multidisciplinary intervention program (MIP, n = 27) for weight loss. Body weight, body composition assessed by bioelectrical impedance analysis, and serum protein levels were measured before and within 12 months after intervention.
  
  
  RESULTS
  After 1 year of observation, excess weight loss was more pronounced following LSG (65 %) compared to MIP (38 %, p < 0.001). In both groups, body fat was clearly reduced, but a higher reduction occurred in the LSG group. However, protein status deteriorated particularly in the LSG group. Within 1 year, body cell mass declined from 37.1 to 26.9 kg in the LSG group, but only from 35.7 to 32.2 kg in the MIP group. This resulted in an increased mean extracellular mass/body cell mass ratio (1.42 versus 1.00, p < 0.001), in a decreased mean phase angle (4.4° versus 6.6°, p < 0.001), and in a lower prealbumin level in serum (p < 0.02) in the LSG group compared to the MIP group.
  
  
  CONCLUSIONS
  LSG, compared to MIP, was more effective regarding excess weight loss and body fat loss within 1 year, however, induced more pronounced muscle mass and protein loss, possibly requiring particular interventions such as exercise or protein supplements.
authors.affiliation: Department of Nutritional Medicine, University of Hohenheim, Fruwirthstraße 12, 70593, Stuttgart, Germany, asja.friedrich@uni-hohenheim.de.
authors.forename: Asja E
authors.initials: AE
authors.lastname: Friedrich
authors.forename: Antje
authors.initials: A
authors.lastname: Damms-Machado
authors.forename: Tobias
authors.initials: T
authors.lastname: Meile
authors.forename: Nicole
authors.initials: N
authors.lastname: Scheuing
authors.forename: Katrin
authors.initials: K
authors.lastname: Stingel
authors.forename: Maryam
authors.initials: M
authors.lastname: Basrai
authors.forename: Markus A
authors.initials: MA
authors.lastname: Küper
authors.forename: Klaus M
authors.initials: KM
authors.lastname: Kramer
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Bischoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D019587:Dietary Supplements; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000378:metabolism / Q000628:therapy*; D010348:Patient Care Team; D015397:Program Evaluation; D011502:Protein-Energy Malnutrition / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods