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Preoperative Fat-Free Mass: A Predictive Factor of Weight Loss after Gastric Bypass

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Abstract

Weight loss failure occurs in 8 % to 40 % of patients after gastric bypass (GBP). The aim of our study was to analyse the predictive factors of weight loss at 1 year so as to select the best candidates for this surgery and reduce the failures. We included 73 patients treated by laparoscopic GBP. We retrospectively analysed the predictive factors of weight loss in kilograms as well as excess weight loss in percentage (EWL%) at 1 year. The population was divided into tertiles so as to compare the sub-group with the highest weight loss with the sub-group with the least satisfactory results. The significantly predictive factors of a better weight loss in kilograms were male, higher initial weight (144 versus 118 kg, p = 0.002), a significant early weight loss and a higher preoperative percentage of fat-free mass (FFM%; p = 0.03). A higher FFM% was also associated with a better EWL% (p = 0.004). The preoperative FFM (in kilograms) was the principal factor accounting for the weight loss at 1 year regardless of age, gender, height and initial body mass index (BMI; p < 0.0001). There was a better correlation between FFM and weight loss (Spearman test, p = 0.0001) than between initial BMI and weight loss (p = 0.016). We estimated weight loss at 1 year according to initial FFM using the formula: 0.5 kg of lost weight per kilogram of initial FFM. The initial FFM appears to be a decisive factor in the success of GBP. Thus, the sarcopoenic patients would appear to be less suitable candidates for this surgery.

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Conflicts of interest

The authors certify having no disclosure and no commercial interest in the subject of study.

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Authors and Affiliations

  1. Department of Digestive Surgery and Bariatric Surgery, Hospices Civils de Lyon, Edouard Herriot Hospital, Université Claude Bernard Lyon1, 5, Place d’Arsonval, 69 437, Lyon, France

    Maud Robert, Elise Pelascini, Philippe Espalieu, Gilles Poncet & Christian Gouillat

  2. Department of Endocrinology, Diabetology and Nutrition, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 165, chemin du Grand Revoyet, 69530, Pierre Bénite, France

    Emmanuel Disse & Martine Laville

  3. Unité INSERM 1060, laboratoire CARMEN, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon1, 165, chemin du Grand Revoyet, 69530, Pierre Bénite, France

    Maud Robert, Emmanuel Disse & Martine Laville

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  1. Maud Robert
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  2. Elise Pelascini
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  3. Emmanuel Disse
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  4. Philippe Espalieu
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Correspondence to Maud Robert.

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Robert, M., Pelascini, E., Disse, E. et al. Preoperative Fat-Free Mass: A Predictive Factor of Weight Loss after Gastric Bypass. OBES SURG 23, 446–455 (2013). https://doi.org/10.1007/s11695-012-0781-2

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  • DOI: https://doi.org/10.1007/s11695-012-0781-2

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