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A Comparison of the Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Body Mass Composition as Measured by Air Displacement Plethysmography

Abstract

Background

The laparoscopic sleeve gastrectomy (LSG) is now the most commonly performed bariatric surgery in the world. Multiple studies have demonstrated the equivalence between the LSG and Roux-en-Y gastric bypass (RYGB) with regard to weight loss and comorbidity resolution. Few studies have examined the differences in body mass composition change between the two procedures.

Methods

Sixty-three patients undergoing either LSG or RYGB underwent calculation of total body mass, ideal body mass, lean mass, and fat mass by air displacement plethysmography (BodPodtm) prior to surgery and at 12 months postoperatively. Calculations of excess body weight, % excess weight loss, change in % fat mass, and change in % lean mass were then performed at each time interval.

Results

Thirty-three patients underwent LSG and 30 patients underwent RYGB. Mean percent excess weight loss in the LSG and RYGB group was 47.2% and 53.4% respectively (p = 0.165, 95% CI − 14.8–2.6). Mean percent change in fat mass for the LSG group and RYGB group was 9.2% and 10.51% respectively (p = 0.249, 95% CI − 0.86–3.2). Mean percent change in lean mass for the LSG group and RYGB group was 9.4% and 10.49% respectively (p = 0.383, 95% CI 2.85–1.13).

Conclusion

The LSG and RYGB both impart dramatic meaningful loss in excess body weight. In addition, both the LSG and RYGB impart dramatic reductions in fat mass. However, both procedures induce loss of lean mass and there appears to be no difference between the two procedures in this regard despite their anatomic and physiologic differences.

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Funding

This project was supported by a research grant from Medtronic Surgical Innovations External Research Program (grant number 17448000).

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Correspondence to Peter Nau.

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Data collection and patient investigation were performed following official review and IRB approval (IRB ID No. 201310819). In all cases, informed consent was obtained from the individual participants included in the study.

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The authors declare that they have no conflicts of interest.

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Kavanagh, R., Smith, J., Avgenackis, E. et al. A Comparison of the Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Body Mass Composition as Measured by Air Displacement Plethysmography. OBES SURG 30, 451–455 (2020). https://doi.org/10.1007/s11695-019-04178-8

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Keywords

  • Bariatric surgery
  • Body composition
  • Gastric bypass
  • Sleeve gastrectomy