Comparison of Energy and Food Intake Between Gastric Bypass and Sleeve Gastrectomy: a Meta-analysis and Systematic Review

  • Parisa Janmohammadi
  • Forough Sajadi
  • Shahab Alizadeh
  • Elnaz DaneshzadEmail author
Review Article


Obesity is a developed nutritional problem, and today, surgery is one of the approaches to cure it. A good understanding of the variations in food intake will be beneficial for sustaining long-term weight loss post-surgery and for improving nutrition care strategies. The purpose of this review was the comparison of the impact of two methods of gastric bypass (GBP) and sleeve gastrectomy (SG) on dietary intake. Databases of PubMed, Embase, Scopus, Google Scholar, and Web of science were used for the literature search up to June 2018. We concluded the studies that measured mean daily energy intake and the percent of macronutrients from total calorie intake of before and after GBP and SG. A total of 18 studies were finally included in the meta-analysis for the effect of bariatric surgery on food intake. Bariatric surgery significantly decreased energy intake by 1050.04 kcal/day (p < 0.001) compared with the baseline values of energy intake. The pooled effect of bariatric surgery on protein intake was 0.82 g/day (p = 0.004) compared with the baseline values. The pooled analysis found no significant impact of bariatric surgery on carbohydrate intake (WMD = 0.56 g/day; p = 0.40) compared with the baseline values. The pooled estimate of effect for bariatric surgery on fat intake was − 1.34 g/day (p = 0.006). This study demonstrates that bariatric surgery might be effective on energy and fat intake; however, there was no effect on carbohydrate intake.


Body mass index Bariatric surgery Roux-en-Y gastric bypass Meta-analysis 



Thanks to the reviewers whose input considerably strengthened the paper.


PJ and FS searched and wrote the paper; both of them separately did the exclusion and inclusion processes of articles, data extraction, and quality assessment. Any problem solved by ED. Sha analyzed data. ED commented on and edit the paper, also supervised the whole study.

Compliance with Ethical Standards

The present study is a systematic review and meta-analysis; therefore, informed consent was not needed.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The present study was approved and supported by Exceptional Talent Development Center (ETDC), Tehran University of Medical Sciences (grant no.: 97-03-61-39369).

Supplementary material

11695_2018_3663_MOESM1_ESM.docx (166 kb)
ESM 1 (DOCX 166 kb)


  1. 1.
    Bavaresco M, Paganini S, Lima TP, et al. Nutritional course of patients submitted to bariatric surgery. Obes Surg. 2010;20(6):716–21.CrossRefGoogle Scholar
  2. 2.
    Kruseman M, Leimgruber A, Zumbach F, et al. Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010;110(4):527–34.CrossRefGoogle Scholar
  3. 3.
    Johnson LK, Andersen LF, Hofsø D, et al. Dietary changes in obese patients undergoing gastric bypass or lifestyle intervention: a clinical trial. Br J Nutr. 2013;110(1):127–34.CrossRefGoogle Scholar
  4. 4.
    le Roux CW et al. Gastric bypass reduces fat intake and preference. Am J Phys Regul Integr Comp Phys. 2011;301(4):6.Google Scholar
  5. 5.
    Molin Netto BD, Earthman CP, Farias G, et al. Eating patterns and food choice as determinant of weight loss and improvement of metabolic profile after RYGB. Nutrition. 2017;33:125–31.CrossRefGoogle Scholar
  6. 6.
    Moize V et al. Nutritional intake and prevalence of nutritional deficiencies prior to surgery in a Spanish morbidly obese population. Obes Surg. 2011;21(9):1382–8.CrossRefGoogle Scholar
  7. 7.
    El Labban S, Safadi B, Olabi A. The effect of Roux-en-Y gastric bypass and sleeve gastrectomy surgery on dietary intake, food preferences, and gastrointestinal symptoms in post-surgical morbidly obese Lebanese subjects: a cross-sectional pilot study. Obes Surg. 2015;25(12):2393–9.CrossRefGoogle Scholar
  8. 8.
    Verger EO, Aron-Wisnewsky J, Dao MC, et al. Micronutrient and protein deficiencies after gastric bypass and sleeve gastrectomy: a 1-year follow-up. Obes Surg. 2016;26(4):785–96.CrossRefGoogle Scholar
  9. 9.
    Coupaye M, Rivière P, Breuil MC, et al. Comparison of nutritional status during the first year after sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Surg. 2014;24(2):276–83.CrossRefGoogle Scholar
  10. 10.
    Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–8.CrossRefGoogle Scholar
  11. 11.
    Nicoletti CF et al. Protein and amino acid status before and after bariatric surgery: a 12-month follow-up study. Surg Obes Relat Dis. 2013;9(6):1008–12.CrossRefGoogle Scholar
  12. 12.
    Nielsen MS, Christensen BJ, Ritz C, et al. Roux-En-Y gastric bypass and sleeve gastrectomy does not affect food preferences when assessed by an ad libitum buffet meal. Obes Surg. 2017;27(10):2599–605.CrossRefGoogle Scholar
  13. 13.
    Chou JJ, Lee WJ, Almalki O, et al. Dietary intake and weight changes 5 years after laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(12):3240–6.CrossRefGoogle Scholar
  14. 14.
    Dagan SS, Zelber-Sagi S, Webb M, et al. Nutritional status prior to laparoscopic sleeve gastrectomy surgery. Obes Surg. 2016;26(9):2119–26.CrossRefGoogle Scholar
  15. 15.
    Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrinol. 2008;158(2):135–45.CrossRefGoogle Scholar
  16. 16.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292(14):1724–37.CrossRefGoogle Scholar
  17. 17.
    Giusti V, Suter M, Héraïef E, et al. Effects of laparoscopic gastric banding on body composition, metabolic profile and nutritional status of obese women: 12-months follow-up. Obes Surg. 2004;14(2):239–45.CrossRefGoogle Scholar
  18. 18.
    Brolin R et al. Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg. 1994;220(6):782–90.CrossRefGoogle Scholar
  19. 19.
    Trostler N, Mann A, Zilberbush N, et al. Weight loss and food intake 18 months following vertical banded gastroplasty or gastric bypass for severe obesity. Obes Surg. 1995;5(1):39–51.CrossRefGoogle Scholar
  20. 20.
    Bobbioni-Harsch E, Huber O, Morel P, et al. Factors influencing energy intake and body weight loss after gastric bypass. Eur J Clin Nutr. 2002;56(6):551–6.CrossRefGoogle Scholar
  21. 21.
    Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.CrossRefGoogle Scholar
  22. 22.
    Moizé V, Andreu A, Rodríguez L, et al. Protein intake and lean tissue mass retention following bariatric surgery. Clin Nutr. 2013;32(4):550–5.CrossRefGoogle Scholar
  23. 23.
    Mercachita T, Santos Z, Limão J, et al. Anthropometric evaluation and micronutrients intake in patients submitted to laparoscopic Roux-en-Y gastric bypass with a postoperative period of≥ 1 year. Obes Surg. 2014;24(1):102–8.CrossRefGoogle Scholar
  24. 24.
    Moizé V, Andreu A, Flores L, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.CrossRefGoogle Scholar
  25. 25.
    Laurenius A, Larsson I, Melanson KJ, et al. Decreased energy density and changes in food selection following Roux-en-Y gastric bypass. Eur J Clin Nutr. 2013;67(2):168–73.CrossRefGoogle Scholar
  26. 26.
    Miller GD, Norris A, Fernandez A. Changes in nutrients and food groups intake following laparoscopic Roux-en-Y gastric bypass (RYGB). Obes Surg. 2014;24(11):1926–32.CrossRefGoogle Scholar
  27. 27.
    Giusti V, Theytaz F, di Vetta V, et al. Energy and macronutrient intake after gastric bypass for morbid obesity: a 3-y observational study focused on protein consumption. Am J Clin Nutr. 2015;103(1):18–24.CrossRefGoogle Scholar
  28. 28.
    Aron-Wisnewsky J, Verger EO, Bounaix C, et al. Nutritional and protein deficiencies in the short term following both gastric bypass and gastric banding. PLoS One. 2016;11(2):e0149588.CrossRefGoogle Scholar
  29. 29.
    Coluzzi I, Raparelli L, Guarnacci L, et al. Food intake and changes in eating behavior after laparoscopic sleeve gastrectomy. Obes Surg. 2016;26(9):2059–67.CrossRefGoogle Scholar
  30. 30.
    Jeffreys RM, Hrovat K, Woo JG, et al. Dietary assessment of adolescents undergoing laparoscopic Roux-en-Y gastric bypass surgery: macro-and micronutrient, fiber, and supplement intake. Surg Obes Relat Dis. 2012;8(3):331–6.CrossRefGoogle Scholar
  31. 31.
    de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6(1):79–85.CrossRefGoogle Scholar
  32. 32.
    Burge JC et al. Changes in patients’ taste acuity after Roux-en-Y gastric bypass for clinically severe obesity. J Am Diet Assoc. 1995;95(6):666–70.CrossRefGoogle Scholar
  33. 33.
    Ochner CN, Kwok Y, Conceição E, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg. 2011;253(3):502–7.CrossRefGoogle Scholar
  34. 34.
    Behary P, Miras AD. Food preferences and underlying mechanisms after bariatric surgery. Proc Nutr Soc. 2015;74(4):419–25.CrossRefGoogle Scholar
  35. 35.
    Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4):469–75.CrossRefGoogle Scholar
  36. 36.
    Mechanick JI et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity. 2009;17(S1):S3–S72.CrossRefGoogle Scholar
  37. 37.
    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(5):715–22.CrossRefGoogle Scholar
  38. 38.
    Näslund I, Järnmark I, Andersson H. Dietary intake before and after gastric bypass and gastroplasty for morbid obesity in women. Int J Obes. 1988;12(6):503–13.Google Scholar
  39. 39.
    Thomas JR, Gizis F, Marcus E. Food selections of Roux-en-Y gastric bypass patients up to 2.5 years postsurgery. J Am Diet Assoc. 2010;110(4):608–12.CrossRefGoogle Scholar
  40. 40.
    Fujioka K. Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005;28(2):481–4.CrossRefGoogle Scholar
  41. 41.
    Gentilcore D, Chaikomin R, Jones KL, et al. Effects of fat on gastric emptying of and the glycemic, insulin, and incretin responses to a carbohydrate meal in type 2 diabetes. J Clin Endocrinol Metab. 2006;91(6):2062–7.CrossRefGoogle Scholar
  42. 42.
    Ponsky TA, Brody F, Pucci E. Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass. J Am Coll Surg. 2005;201(1):125–31.CrossRefGoogle Scholar
  43. 43.
    Palazuelos-Genis T, Mosti M, Sánchez-Leenheer 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):1–4.CrossRefGoogle Scholar
  44. 44.
    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):E1080–8.CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  1. 1.Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences (TUMS)TehranIran
  2. 2.Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences (TUMS)TehranIran

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