title: Super obese behave different from simple and morbid obese patients in the changes of body composition after tailored one anastomosis gastric bypass (BAGUA).
abstract: BACKGROUND
  Super obese patients behave different from simple and morbid obese patients when they reach final changes of body composition (BC) after bariatric surgery. This has led us to tailor One Anastomosis Gastric Bypass (BAGUA) to achieve better results in this group of patients.
  
  
  METHODS
  We studied 83 (37 diabetic and 46 nondiabetic BMI 30 and up) patients who completed all evaluation appointment (preoperative, 10 days, 1, 3, 6 and 12 months) after tailored BAGUA for diabesity. We used the Tanita body composition analyzer BC-420 MA by the method of single frequency impedance to analyze the evolution of BC in patients classified by BMI 30 - 34,9, 35 - 50, and >50.
  
  
  RESULTS
  While preoperative excess weight presented dramatic decreases after tailored BAGUA in all the groups, super obese have different final BC. Diabetics retained more fat mass and visceral fat, where super obese have double (14 kg) that simple obese patients (6 kg), they lost more muscle mass, and have higher basal metabolism. The final BC is altered in all parameters if diabetes is added.
  
  
  CONCLUSIONS
  The reduction of the preoperative excess weight is motivated largely by the tailored effect of BAGUA. Patients BMI 30-50 behaved homogeneous in BC after surgery while patients BMI >50 behave different. Super obese lose less weight, retained more fat mass, visceral fat, bone mass, and total water. This effect should be treated by more aggressive surgery by measuring the entire small intestine to make a proper exclusion (tailored) to achieve homogeneous effects.
authors.affiliation: Dept. of Surgery University Malaga, Spain.. gcaballe@uma.es.
authors.forename: M
authors.initials: M
authors.lastname: García-Caballero
authors.affiliation: Dept. of Surgery University Malaga, Spain.. alexxanderhola@yahoo.com.mx.
authors.forename: A
authors.initials: A
authors.lastname: Reyes-Ortiz
authors.affiliation: Dept. of Surgery University Malaga, Spain.. manugarciasillero@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: García
authors.affiliation: Dept. of Surgery University Malaga, Spain. Autonomous University of the State of México (UAEMex). U.M.F. 229, Del. 16. Mexican Social Security Institute. México.. jmmartinezm@uma.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Martínez-Moreno
authors.affiliation: Dept. of Surgery University Malaga, Spain.. josetoval@telefonica.net.
authors.forename: J-A-
authors.initials: JA
authors.lastname: Toval-Mata
mesh_terms: D001823:Body Composition; D048909:Diabetes Complications; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000523:psychology*; D006801:Humans; D009765:Obesity / Q000523:psychology* / Q000601:surgery*; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D016896:Treatment Outcome