Nutrition Care in Bariatric Surgery

NCBS: Post-operative Energy Needs (2017)

• Assessment
  What is the effect of bariatric surgery on resting metabolic rate in adults?

  • Conclusion
    A total of 10 studies, including gastric bypass and gastric band (with the majority of patients having undergone gastric bypass) reported a clinically meaningful and statistically significant decrease in resting metabolic rate (RMR) after bariatric surgery. Five studies reported a decrease ranging from 12% to 21% during the first six months post-surgery, four studies reported a decrease ranging from 13.5% to 26% at one year and one study reported that an approximately 20% reduction in RMR was sustained at two years. Ongoing research is needed regarding the effect of available bariatric surgical options on RMR. 
  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of bariatric surgery on resting metabolic rate in adults?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Adams T, Pendleton R, Strong M, Kolotkin R, Walker J, Litwin S, Berjaoui W, LaMonte M, Cloward T, Avelar E, Owan T, Nuttall R, Gress R, Crosby R, Hopkins P, Brinton E, Rosamond W, Wiebke G, Yanowitz F, Farney R, Halverson R, Simper S, Smith S, Hunt S. Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese. Obesity (Silver Spring, Md.) 2010; 18:121-130
      • Carrasco F, Papapietro K, Csendes A, Salazar G, Echenique C, Lisboa C, Díaz E, Rojas J. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obesity Surgery 2007; 17:608-616
      • Coupaye M, Bouillot J, Coussieu C, Guy-Grand B, Basdevant A, Oppert J. One-year changes in energy expenditure and serum leptin following adjustable gastric banding in obese women. . Obesity Surgery 2005; 15:827-833
      • Das S, Roberts S, McCrory M, Hsu L, Shikora S, Kehayias J, Dallal G, Saltzman E. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. The American Journal of Clinical Nutrition 2003; 78:22-30
      • del Genio F, Alfonsi L, Marra M, Finelli C, del Genio G, Rossetti G, del Genio A, Contaldo F, Pasanisi F.. Metabolic and nutritional status changes after 10% weight loss in severely obese patients treated with laparoscopic surgery vs. integrated medical treatment. Obes Surg. 2007.; 17:1,592-1,598.
      • Del Genio F, Del Genio G, De Sio I, Marra M, Alfonsi L, Finelli C, Contaldo F, Pasanisi F. Noninvasive evaluation of abdominal fat and liver changes following progressive weight loss in severely obese patients treated with laparoscopic gastric bypass. Obesity Surgery 2009; 19:1,664-1,671
      • Faria S, Faria O, Buffington C, de Almeida Cardeal M, Rodrigues de Gouvêa H. Energy expenditure before and after Roux-en-Y gastric bypass. Obesity Surgery 2012; 22:1,450-1,455
      • Faria S, Faria O, Cardeal M, Ito M, Buffington C. Diet-induced thermogenesis and respiratory quotient after Roux-en-Y gastric bypass surgery: a prospective study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 2014; 10:138-143
      • Liu X, Lagoy A, Discenza I, Papineau G, Lewis E, Braden G, Romanelli J, Braun B, Silva J. Metabolic and neuroendocrine responses to Roux-en-Y gastric bypass. I: energy balance, metabolic changes, and fat loss. The Journal of Clinical Endocrinology and Metabolism 2012; 97:E1440-E1450
      • Rabl C, Rao M, Schwarz J, Mulligan K, Campos G. Thermogenic changes after gastric bypass, adjustable gastric banding or diet alone. Surgery 2014; 156:806-812
  • Search Plan and Results: NCBS: Resting Metabolic Rate 2015