title: Associations of surgical and nonsurgical weight loss with knee musculature: a cohort study of obese adults.
abstract: BACKGROUND
  Marked weight loss reduces lean body mass and quadriceps thickness. It is unclear whether muscle loss varies according to the method of weight loss.
  
  
  OBJECTIVE
  This study compared the association of surgical versus nonsurgical weight loss with change in vastus medialis (VM) properties in obese adults.
  
  
  METHODS
  Twenty obese patients (body mass index ≥ 30 kg/m(2)) who lost weight via laparoscopic gastric banding were matched for weight loss with obese patients who lost weight nonsurgically. The thickness and fat infiltration of VM were assessed at baseline and a mean of 2.4 years later.
  
  
  RESULTS
  After adjusting for confounders, the annual change in VM thickness was -2.9% in the surgical group and -.5% for the nonsurgical group (P = .02). There was also a tendency toward an increased risk for VM fat infiltration to be reduced when weight loss occurred nonsurgically (OR 5.1, 95% CI .8-32.8; P = .09).
  
  
  CONCLUSIONS
  Compared with nonsurgical weight loss, laparoscopic gastric banding was associated with greater VM muscle thickness loss. Relative to laparoscopic gastric banding, there was also a tendency toward an increased risk for VM fat infiltration to be reduced with nonsurgical weight loss. Close attention to preserving muscle properties at the knee when significant amounts of weight loss have occurred is required. Physical therapy may be important in the management of patients after laparoscopic gastric banding in an attempt to preserve skeletal muscle mass.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Teichtahl
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia.
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia.
authors.forename: Pushpika N
authors.initials: PN
authors.lastname: Wijethilake
authors.affiliation: Department of Medicine, Monash University, Melbourne, Australia.
authors.forename: Boyd
authors.initials: B
authors.lastname: Strauss
authors.affiliation: University of Melbourne, Department of Medicine, Austin Hospital, Melbourne, Australia.
authors.forename: Joseph
authors.initials: J
authors.lastname: Proietto
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: John B
authors.initials: JB
authors.lastname: Dixon
authors.affiliation: Menzies Research Institute, Hobart, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Forbes
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia. Electronic address: flavia.cicuttini@monash.edu.
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D049088:Bariatrics / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology*; D009767:Obesity, Morbid / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015431:Weight Loss / Q000502:physiology*
keywords: Bariatric; Knee; Muscle; Obesity; Weight