Review: Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status

Meena Shah, Vinaya Simha, Abhimanyu Garg

Research output: Contribution to journalReview article

293 Citations (Scopus)

Abstract

Context: The number of patients who undergo Roux-en-Y gastric bypass (RYGB) and gastric banding (GB) surgeries has increased dramatically over the past decade, yet the long-term impact of these surgeries on body weight, comorbidities, and nutritional status remains unclear, as do the mechanisms of weight regain. Evidence Acquisition: The articles were found via PubMed searches. To review the impact of bariatric surgery on weight maintenance and comorbidities, only articles with a postoperative follow-up of 3 yr or longer were included. The articles on nutritional status had a follow-up of 12 months or longer. Conclusions: RYGB and GB surgeries lead to substantial weight loss in individuals with morbid obesity. However, significant weight regain occurs over the long term, and according to the only well-designed prospective controlled study, the improvement in comorbidities associated with weight loss mitigates in the long term on weight regain. There is some evidence from a retrospective study that RYGB surgery is associated with a modest decrease in long-term mortality. These results remain to be substantiated by well-designed, long-term, randomized and prospective controlled studies. The mechanisms that lead to weight regain need to be further examined and may include increase in energy intake due to enlargement of stoma and adaptive changes in the levels of gut and adipocyte hormones such as ghrelin and leptin, which regulate energy intake; decrease in physical activity; changes in energy expenditure; and other factors. In addition to weight regain, RYGB surgery is associated with frequent incidence of iron, vitamin B12, folate, calcium, and vitamin D deficiency, which requires regular supplementation and monitoring.

Original languageEnglish (US)
Pages (from-to)4223-4231
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume91
Issue number11
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

Fingerprint

Bariatric Surgery
Regain
Nutritional Status
Surgery
Comorbidity
Gastric Bypass
Body Weight
Weights and Measures
Energy Intake
Weight Loss
Stomach
Prospective Studies
Ghrelin
Vitamin D Deficiency
Morbid Obesity
Vitamin B 12
Leptin
Folic Acid
Adipocytes
PubMed

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Review : Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. / Shah, Meena; Simha, Vinaya; Garg, Abhimanyu.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 91, No. 11, 01.01.2006, p. 4223-4231.

Research output: Contribution to journalReview article

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