Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Recruitment
2.2. Study Design and Timeline
2.3. Biometrics and Dietary Recall
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Excess Weight Loss and Responder Status
3.3. Changes in Total Energy and Macronutrient Intake
3.4. Direct Associations between Nutrient Intake and %EWL at 12-, 18-, and 24-Months
3.5. Changes in Total Energy and Macronutrient Intake over Time by Weight Loss Response
3.5.1. Dietary Intake and Weight Loss Outcomes at 12 Months
3.5.2. Dietary Intake and Weight Loss Outcomes at 18 Months
3.5.3. Dietary Intake and Weight Loss Outcomes at 24 Months
3.6. Differences in Sample Size and Power Do Not Explain Differences in Outcome between 12 and 24 Months
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Timepoint | n | Weight (kg) | BMI (kg/m2) | Percent Loss (%) | EWL (%) |
---|---|---|---|---|---|
Baseline | 124 | 131.64 ± 25.21 | 45.93 ± 6.79 | - | - |
RYGB—87 | 129.51 ± 21.58 | 45.28 ± 5.66 | - | - | |
SG—37 | 136.66 ± 31.97 | 47.46 ± 8.82 | - | - | |
Postop 1 month | 122 | 115.89 ± 22.41 | 40.52 ± 6.37 | 11.81 ± 3.44 | 27.32 ± 8.94 |
RYGB—86 | 114.07 ± 18.46 | 39.9 ± 5.02 | 12.02 ± 3.4 | 27.77 ± 8.49 | |
SG—36 | 120.23 ± 29.68 | 41.99 ± 8.72 | 11.31 ± 3.55 | 26.23 ± 9.96 | |
Postop 6 months | 114 | 97.85 ± 20.93 | 34.37 ± 6.09 | 25.3 ± 5.95 | 58.32 ± 16.36 |
RYGB—79 | 94.29 ± 15.76 | 33.26 ± 4.58 | 26.69 ± 5.66 *** | 61.53 ± 15.16 ** | |
SG—35 | 105.88 ± 28.12 * | 36.88 ± 8.1 * | 22.15 ± 5.43 | 51.09 ± 16.88 | |
Postop 12 months | 110 | 93.13 ± 21.66 | 32.69 ± 6.34 | 28.79 ± 7.99 | 66.51 ± 21.19 |
RYGB—74 | 88.32 ± 16.32 | 31.12 ± 4.68 | 31 ± 7.29 *** | 71.85 ± 19.44 *** | |
SG—36 | 103.02 ± 27.5 ** | 35.91 ± 7.99 ** | 24.23 ± 7.52 | 55.53 ± 20.64 | |
Postop 18 months | 101 | 93.31 ± 21.76 | 32.73 ± 6.16 | 28.25 ± 8.48 | 65.46 ± 21.93 |
RYGB—67 | 88.61 ± 17.32 | 31.21 ± 4.86 | 30.46 ± 8.57 *** | 70.81 ± 21.98 *** | |
SG—34 | 102.58 ± 26.5 ** | 35.73 ± 7.32 ** | 23.89 ± 6.45 | 54.93 ± 17.86 | |
Postop 24 months | 93 | 94.87 ± 21.64 | 33.36 ± 6.41 | 27.25 ± 9.26 | 62.59 ± 23.8 |
RYGB—64 | 89.3 ± 17.45 | 31.62 ± 5.03 | 29.45 ± 9.01 *** | 68.47 ± 23.24 *** | |
SG—29 | 107.18 ± 25 ** | 37.19 ± 7.5 ** | 22.42 ± 7.99 | 49.62 ± 19.82 |
Responder | Suboptimal Responder | ||||
---|---|---|---|---|---|
(n = 85) | (n = 25) | R2 | p-Value | ||
Baseline | Weight (kg) | 126.01 ± 21.13 | 146.67 ± 31.57 | 0.118 | 0.002 |
Energy (kcal) | 1865.58 ± 842.97 | 1973.37 ± 756.42 | 0.003 | 0.392 | |
Carbohydrates (g) | 198.29 ± 119.14 (43.7%) | 209.78 ± 101.33 (46.5%) | 0.002 | 0.448 | |
Protein (g) | 109.6 ± 86.56 (27.7%) | 117.28 ± 70.75 (30.2%) | 0.002 | 0.267 | |
Total fat (g) | 98.8 ± 94.24 (52.4%) | 111.46 ± 70.2 (62.8%) | 0.004 | 0.053 | |
Postop | Weight (kg) | 110.27 ± 18.12 | 130.76 ± 29.13 | 0.143 | 0.001 |
1 month | Energy (kcal) | 668.69 ± 253.94 | 930.85 ± 295.61 | 0.148 | <0.001 |
Carbohydrates (g) | 58.41 ± 50.72 (35.8%) | 79.96 ± 47.85 (33.5%) | 0.031 | 0.013 | |
Protein (g) | 59.97 ± 45.52 (36.8%) | 64.17 ± 22.47 (28.9%) | 0.002 | 0.105 Δ | |
Total fat (g) | 33.71 ± 44.01 (46.7%) | 39.33 ± 17.15 (37.5%) | 0.003 | 0.007 | |
Postop | Weight (kg) | 91.35 ± 15.01 | 119.82 ± 25.38 | 0.311 | <0.001 |
6 months | Energy (kcal) | 1021.7 ± 427.11 | 1285.95 ± 458.12 | 0.06 | 0.009Δ |
Carbohydrates (g) | 91.51 ± 63.07 (35.1%) | 110.9 ± 54.65 (34.4%) | 0.017 | 0.038Δ | |
Protein (g) | 74.4 ± 53.24 (30.9%) | 76.09 ± 28.62 (24.0%) | <0.001 | 0.247 | |
Total fat (g) | 50.88 ± 48.29 (45.0%) | 59.21 ± 25.22 (41.2%) | 0.006 | 0.017Δ | |
Postop | Weight (kg) | 85.72 ± 14.63 | 118.35 ± 22.9 | 0.402 | <0.001 |
12 months | Energy (kcal) | 1156.08 ± 416.19 | 1436.55 ± 466.82 | 0.072 | 0.018Δ |
Carbohydrates (g) | 110.25 ± 61.81 (36.8%) | 116.61 ± 58.31 (31.1%) | 0.002 | 0.685 Δ | |
Protein (g) | 71.27 ± 36.12 (26.0%) | 85.48 ± 24.49 (25.1%) | 0.031 | 0.002Δ | |
Total fat (g) | 52.42 ± 33.14 (40.6%) | 66.43 ± 25.31 (41.5%) | 0.034 | 0.005Δ |
Responder | Suboptimal Responder | ||||
---|---|---|---|---|---|
(n = 64) | (n = 29) | R2 | p-Value | ||
Baseline | Weight (kg) | 126.81 ± 19.42 | 138.62 ± 32.7 | 0.049 | 0.121 |
Energy (kcal) | 1807.96 ± 681.19 | 1820.37 ± 762.13 | <0.001 | 0.879 | |
Carbohydrates (g) | 179.03 ± 81.77 (38.7%) | 222.75 ± 161.77 (53%) | 0.032 | 0.673 | |
Protein (g) | 91.19 ± 28.57 (21.8%) | 141.41 ± 141 (38.3%) | 0.077 | 0.167 | |
Total fat (g) | 76.24 ± 31.16 (37.7%) | 133.3 ± 142.57 (79.2%) | 0.094 | 0.048 | |
Postop | Weight (kg) | 110.99 ± 16.18 | 124.25 ± 30.1 | 0.077 | 0.042 |
1 month | Energy (kcal) | 676.96 ± 263.61 | 833.98 ± 291.5 | 0.068 | 0.011 |
Carbohydrates (g) | 58.46 ± 49.11 (34.8%) | 69.71 ± 41.96 (32.8%) | 0.012 | 0.094 | |
Protein (g) | 58.87 ± 42.55 (36.9%) | 62.09 ± 24.22 (30.4%) | 0.002 | 0.229 Δ | |
Total fat (g) | 32.14 ± 41.13 (45%) | 34.11 ± 15.19 (36.6%) | 0.001 | 0.091 | |
Postop | Weight (kg) | 92 ± 14.54 | 110.37 ± 27.77 | 0.162 | <0.001 |
6 months | Energy (kcal) | 1016.07 ± 434.96 | 1206.94 ± 488.45 | 0.037 | 0.053 Δ |
Carbohydrates (g) | 90.74 ± 67.43 (35.1%) | 99.74 ± 53.14 (33%) | 0.004 | 0.205 Δ | |
Protein (g) | 77.92 ± 60.31 (32.5%) | 75.54 ± 31.86 (25.5%) | <0.001 | 0.39 | |
Total fat (g) | 53.3 ± 55.04 (47.7%) | 54.91 ± 26.24 (40.2%) | <0.001 | 0.086 Δ | |
Postop | Weight (kg) | 85.46 ± 14.82 | 109.01 ± 26.16 | 0.252 | <0.001 |
12 months | Energy (kcal) | 1143.68 ± 426.09 | 1338 ± 476.48 | 0.04 | 0.141 Δ |
Carbohydrates (g) | 108.7 ± 66.45 (36.3%) | 109.96 ± 57.76 (31.6%) | <0.001 | 0.905 Δ | |
Protein (g) | 72.11 ± 38.97 (26.9%) | 84.65 ± 25.65 (26.9%) | 0.026 | 0.005Δ | |
Total fat (g) | 52.15 ± 36.69 (40.8%) | 61.4 ± 27.24 (40.8%) | 0.016 | 0.109 Δ | |
Postop | Weight (kg) | 85.99 ± 14.88 | 110.35 ± 24.31 | 0.28 | <0.001 |
18 months | Energy (kcal) | 1261.91 ± 498.21 | 1364.14 ± 530.58 | 0.009 | 0.467 |
Carbohydrates (g) | 121.91 ± 61.32 (37.4%) | 121.67 ± 60.63 (35.3%) | <0.001 | 0.754 | |
Protein (g) | 65.56 ± 21.83 (22.7%) | 84.3 ± 28.94 (25.2%) | 0.115 | 0.003 | |
Total fat (g) | 53.67 ± 23.26 (38.3%) | 59.44 ± 25.43 (39.1%) | 0.012 | 0.402 | |
Postop | Weight (kg) | 86.36 ± 14.77 | 113.67 ± 22.7 | 0.346 | <0.001 |
24 months | Energy (kcal) | 1218.42 ± 472.41 | 1296.49 ± 542.18 | 0.005 | 0.451 |
Carbohydrates (g) | 116.14 ± 62.55 (39.9%) | 121.33 ± 71.11 (36.3%) | 0.001 | 0.808 | |
Protein (g) | 75.65 ± 41.86 (28.6%) | 71.23 ± 22.48 (23.9%) | 0.003 | 0.976 | |
Total fat (g) | 56.64 ± 43.52 (47.6%) | 53.28 ± 21.87 (38%) | 0.002 | 0.724 |
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Sorgen, A.A.; Fodor, A.A.; Steffen, K.J.; Carroll, I.M.; Bond, D.S.; Crosby, R.; Heinberg, L.J. Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Nutrients 2023, 15, 3323. https://doi.org/10.3390/nu15153323
Sorgen AA, Fodor AA, Steffen KJ, Carroll IM, Bond DS, Crosby R, Heinberg LJ. Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Nutrients. 2023; 15(15):3323. https://doi.org/10.3390/nu15153323
Chicago/Turabian StyleSorgen, Alicia A., Anthony A. Fodor, Kristine J. Steffen, Ian M. Carroll, Dale S. Bond, Ross Crosby, and Leslie J. Heinberg. 2023. "Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy" Nutrients 15, no. 15: 3323. https://doi.org/10.3390/nu15153323