Obesity Surgery

, Volume 23, Issue 12, pp 1957–1965

Laparoscopic Sleeve Gastrectomy Compared to a Multidisciplinary Weight Loss Program for Obesity—Effects on Body Composition and Protein Status

  • Asja E. Friedrich
  • Antje Damms-Machado
  • Tobias Meile
  • Nicole Scheuing
  • Katrin Stingel
  • Maryam Basrai
  • Markus A. Küper
  • Klaus M. Kramer
  • Alfred Königsrainer
  • Stephan C. Bischoff
Original Contributions

DOI: 10.1007/s11695-013-1036-6

Cite this article as:
Friedrich, A.E., Damms-Machado, A., Meile, T. et al. OBES SURG (2013) 23: 1957. doi:10.1007/s11695-013-1036-6

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.

Keywords

Laparoscopic sleeve gastrectomyFormula dietBody compositionProtein–energy malnutritionBody cell massPhase angle

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Asja E. Friedrich
    • 1
  • Antje Damms-Machado
    • 1
  • Tobias Meile
    • 2
  • Nicole Scheuing
    • 1
  • Katrin Stingel
    • 1
  • Maryam Basrai
    • 1
  • Markus A. Küper
    • 2
  • Klaus M. Kramer
    • 3
  • Alfred Königsrainer
    • 2
  • Stephan C. Bischoff
    • 1
  1. 1.Department of Nutritional MedicineUniversity of HohenheimStuttgartGermany
  2. 2.Department of General, Visceral and Transplant SurgeryUniversity of TuebingenTuebingenGermany
  3. 3.Department of General and Visceral SurgeryChirurgische Klinik Muenchen-BogenhausenMunichGermany