Obesity Surgery

, Volume 29, Issue 9, pp 3054–3061 | Cite as

Assessment of Changes in Body Composition During the First Postoperative Year After Bariatric Surgery

  • Fernanda Guidi Colossi de ParisEmail author
  • Alexandre Vontobel Padoin
  • Cláudio Corá Mottin
  • Marcel Fasolo de Paris



The potential effect of bariatric surgery on weight reduction and improvement of associated comorbidities is known, but the ratio obtained between the components of body weight, including lean body mass, body fat mass, and bone mass, is still not determined. This study aims to verify the changes in body composition during the first year after bariatric surgery.


We conducted a prospective observational cohort study. Fifty patients who underwent bariatric surgery and maintained follow-ups were selected. Patients were assessed preoperatively and postoperatively for periods of 1, 3, 6, and 12 months using tetrapolar bioelectrical impedance analysis and laboratory testing of lipids and serum albumin levels. Data were statistically analyzed.


Statistically significant differences (p < 0.001) were obtained between the preoperative and 12-month evaluation respectively, for body mass index (BMI) (45.8 ± 7.5 to 30.0 ± 4.8 kg/m2), FM (64.7 ± 15.5 to 30.6 ± 9.8 kg), PFM (51.6 ± 4.17 to 37.3 ± 7.6%), and total cholesterol levels (197.1 ± 49.8 to 169.8 ± 31.0 mg/dL). The decrease in PFM shows a better proportion between the body components. PFM showed significantly higher decrease in males than in females (p = 0.012). Lean body mass (p = 0.000) reduction was highest for patients operated by the Unified Health System (SUS, Government of Brazil) probably because of its few financial resources to maintain postoperative care.


The change in body composition of patients who underwent Roux-en-Y gastric bypass was statistically significant for all variables examined during the first year postoperatively. This shows the effectiveness of the surgical procedure and clinical protocol set, which tends to favor a better health prognosis and weight maintenance in the long term.


Bariatric surgery Gastrointestinal bypass Morbid obesity Body composition Bioelectrical impedance analysis 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study and only the patients who agreed to participate were included.

Ethical Approval

All procedures of the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Olbers T, Björkman S, Lindroos A, et al. Body composition, dietary intake, and energy expenditure after laparoscopic Roux-en-Y gastric bypass and laparoscopic vertical banded gastroplasty: a randomized clinical trial. Ann Surg. 2006;244:715–22.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Das SK, Roberts SB, Kehayias JJ, et al. Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery. Am J Physiol Endocrinol Metab. 2003;284(6):1080–8.CrossRefGoogle Scholar
  3. 3.
    Biospace Co. Ltda. Manual InBody520®. 1996–2005 All rights reserved.Google Scholar
  4. 4.
    Heyword VH, Stolarczyk LM. Applied body composition assessment. Hum Kinet. 1996:21–43.Google Scholar
  5. 5.
    Thomas EL, Frost G, Harrington T, et al. Validation of ‘InBody’ bioelectrical impedance by whole body MRI. Laboratory Report. 2001;Google Scholar
  6. 6.
    Jebb SA, Siervo M, Murgatroyd PR, et al. Validity of the leg-to-leg bioimpedance to estimate changes in body fat during weight loss and regain in overweight women: a comparison with multi- compartment models. Int J Obes. 2007;31:756–62.CrossRefGoogle Scholar
  7. 7.
    Alvarez VP, Dixon JB, Strauss BJ, et al. Single frequency bioelectrical impedance is a poor method for determining fat mass in moderately obese women. Obes Surg. 2007;17(2):211–21.CrossRefPubMedGoogle Scholar
  8. 8.
    Salmi JA. Body composition assessment with segmental multifrequency bioimpedance method. J Sports Sci Med. 2003;2(Suppl.3:1–29.Google Scholar
  9. 9.
    Deurenberg P, van der Kooy K, Leenen R, et al. Body impedance is largely dependent on the intra- and extra-cellular water distribution. Eur J Clin Nutr. 1989;43:845.PubMedGoogle Scholar
  10. 10.
    Demura S, Sato S, Kitabayashi T. Percentage of total body fat as estimates by three automatic bioelectrical impedance analyzers. J Physiol Anthropol Appl Hum Sci. 2004;233:93–9.CrossRefGoogle Scholar
  11. 11.
    Deurenberg P. Limitations of the bioelectrical impedance method for the assessment of body fat in severe obesity. Am J Clin Nutr. 1996;64(Suppl.3:449S–52S.CrossRefPubMedGoogle Scholar
  12. 12.
    Stolarczyk LM, Heyward VH, Loan MDV, et al. The fatness-specific bioelectrical impedance analysis equations of Segal et al: are they generalizable and practical? Am J Clin Nutr. 1997;66(1):8–17.CrossRefPubMedGoogle Scholar
  13. 13.
    Chaston TB, Dixon JB, O’Brien PE. Changes in fat free mass during significant weight loss: a systematic review. Int J Obes. 2007;31(5):743–50.CrossRefGoogle Scholar
  14. 14.
    Palazuelos-Genis T, Mosti M, Sanches S, et al. Weight loss and body composition during the first postoperative year of a laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:1–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Madan AK, Kuykendall S, Orth WS, et al. Does laparoscopic gastric bypass result in a healthier body composition? An affirmative answer. Obes Surg. 2006;16:465–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Disschuneit HH, Flechtnes-Mors M, Johnson TD, et al. Metabolic and weight loss effects of a long-term dietary intervention in obese patients. Am J Clin Nutr. 1999;69:198–204.CrossRefGoogle Scholar
  17. 17.
    Garrow JS, Summerbell CD. Meta-analysis: effect of exercise, with and without dieting, on body composition of overweight subjects. Eur J Clin N. 1995;49:1–10.Google Scholar
  18. 18.
    Van Gemert WG, Werterterp KR, Van Acker BAC, et al. Energy, substrate and protein metabolism in morbid obesity before, during and after massive weight loss. Int J Obes. 2000;24:711–8.CrossRefGoogle Scholar
  19. 19.
    Marks BL, Ward A, Morris DH, et al. Fat free mass is maintained in women following a moderate diet and exercise program. Med Sci Sports Exerc. 1995;27:1243–51.CrossRefPubMedGoogle Scholar
  20. 20.
    Ballor D, Poehlman ET. A meta-analysis of the effects of exercise and/or dietary restriction on resting metabolic rate. Eur J Appl Physiol. 1995;71:535–42.CrossRefGoogle Scholar
  21. 21.
    Prentice AM, Oldberg GR, Jebb AS, et al. Physiological responses to slimming. Proc Nutr Soc. 1991;50:441–58.CrossRefPubMedGoogle Scholar
  22. 22.
    Molarius A, Seidell JC, Sans S, et al. Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA Project. Am J Public Health. 2000;90(8):1260–8.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2004;79(1):6–16.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005;82(1):265S–73S.CrossRefPubMedGoogle Scholar
  25. 25.
    Galobardes B, Costanza MC, Bernstein MS, et al. Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993–2000: health inequalities persist. Am J Public Health. 2003;93(8):1302–9.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Schiavo M, Lunardelli A, Oliveira JR. Influência da dieta na concentração sérica de triglicerídeos. Jornal Bras de Patologia e Medicina Clínica e Laboratorial. 2003;39(4):283–8.CrossRefGoogle Scholar
  27. 27.
    Dos Santos NSJ, Draibe AS, Kamimura MA, et al. Albumina sérica como marcador de pacientes em hemodiálise. Rev Nutr Campinas. 2004;17(3):339–49.CrossRefGoogle Scholar
  28. 28.
    Leite S et al. Nutrição e cirurgia bariátrica. Rev Bras Nutr Clin. 2003;18(4):183–9.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculdade de MedicinaPontificia Universidade Catolica do Rio Grande do SulPorto AlegreBrazil
  2. 2.Universidade Federal do Rio Grande do Sul - UFRGSPorto AlegreBrazil

Personalised recommendations