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Relative Energy Expenditure Decreases during the First Year after Bariatric Surgery: A Systematic Review and Meta-Analysis

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Abstract

The effect of bariatric surgery on resting energy expenditure (REE) remains unclear, particularly in terms of the REE/fat-free mass (FFM) ratio. We performed a systematic review with a meta-analysis on Roux-en-Y gastric bypass (RYGB) studies to investigate the effect of bariatric surgery on the REE/FFM ratio 6 and 12 months postoperatively. Five of the 13 records of 6-month data (n = 406) showed a reduction in the REE/FFM ratio without significant summary effects. As regards 12-month data (10 records, n = 713), there was a significant relative REE mean reduction of 1.95 kcal/kg in FFM (CI: −2.82 to −1.09; I2 = 28%; p < 0.00001). These findings suggest that bariatric surgery, specifically RYGB, leads to a decrease in the REE/FFM ratio during the first postoperative year, which may compromise long-term treatment outcomes.

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Acknowledgments

We are particularly thankful to Ananda Araújo, Larissa Valadares, Roberta Borges, and Vivian S.S. Gonçalves for reviewing the manuscript based on the Peer Review of Electronic Search Strategies (PRESS) guidelines.

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Authors and Affiliations

  1. Graduate Program of Human Nutrition, University of Brasília, Brasília, Brazil

    Fernando Lamarca, Mariana Silva Melendez-Araújo, Eliane Said Dutra & Kênia Mara Baiocchi de Carvalho

  2. Candidate for the Health Science Graduate Program, University of Brasília, Brasília, Brazil

    Isabela Porto de Toledo

  3. Faculty of Health Sciences, Graduate Program in Human Nutrition, University of Brasilia, Zip Code 70910-900, Asa Norte, Brasília, Federal District, Brazil

    Kênia Mara Baiocchi de Carvalho

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  1. Fernando Lamarca
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  2. Mariana Silva Melendez-Araújo
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  3. Isabela Porto de Toledo
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  4. Eliane Said Dutra
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Contributions

Fernando Lamarca, Eliane Said Dutra and Kênia Mara Baiocchi de Carvalho wrote the protocol and designed the study. Fernando Lamarca and Mariana Silva Melendez Araújo conducted literature searches, study selection, data collection, data analysis, and manuscript preparation. Isabela Porto de Toledo contributed to literature searches, data analysis, and figure and table conception. All authors reviewed the manuscript and approved the version to be submitted.

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Correspondence to Kênia Mara Baiocchi de Carvalho.

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Table 2 Search strategy and date search was performed in the chosen databases
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Lamarca, F., Melendez-Araújo, M.S., Porto de Toledo, I. et al. Relative Energy Expenditure Decreases during the First Year after Bariatric Surgery: A Systematic Review and Meta-Analysis. OBES SURG 29, 2648–2659 (2019). https://doi.org/10.1007/s11695-019-03934-0

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