Abstract
Background
Weight loss and nutritional status 5 or more years after Roux-en-Y gastric bypass was prospectively documented. The hypothesis was that even after clinical adaptation, imbalances might still occur.
Methods
Seventy-five consecutive patients (age 49.3 ± 10.6 years, 89.3% females) were recruited 83.4 ± 14.3 months after the intervention. Weight loss and nutritional abnormalities were registered.
Results
Body mass index (BMI) was 56.5 ± 10.0 preoperatively, 29.4 ± 6. 2 by 24 months and 34.4 ± 14.6 when last seen. Major current deficit occurred for magnesium (32.1% of the patients), hemoglobin (50.8%), iron (29.8%), ferritin (36.0%), zinc (40.5%), vitamin B12 (61.8%), vitamin D3 (60.5%), and β-carotene (56.8%). Low preoperative measurements had already been unveiled for iron, transferrin, zinc, and vitamin B12. Total drug consumption tended to decrease after operation, and present findings correlated with excess weight loss (EWL). Also presence of diabetes and BMI value were predictors of long-term EWL, along with biochemical profile by 2 years. Multivitamin supplementation and gastrointestinal complaints partially correlated with nutritional results.
Conclusions
(1) Good initial weight loss with moderate late regain, anemia, and multiple nutrient deficits was the common pattern. (2) Massive weight loss, frequent vomiting, dumping syndrome, and women in reproductive age were risk factors for hemoglobin or vitamin deficits, whereas superobesity, diabetes, and use of multiple drugs were associated with EWL result. (3) Most laboratory tests became stable by 2 years and along with BMI correlated with late EWL. (4) Two-year nutritional investigation is especially recommended because of its long-term predictive value.
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Acknowledgments
This investigation was conducted by a multidisciplinary clinical and nutritional team with patients originally registered at the Obesity Surgery Service. The valuable help of Alessandra Rascovski, Alfredo Halpern, and Arthur B. Garrido Jr is appreciated. Financial grants were received from FAPESP 05/53831-0 and CNPq 300392/2008-7. The authors declare no conflict of interest.
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Dalcanale, L., Oliveira, C.P.M.S., Faintuch, J. et al. Long-Term Nutritional Outcome After Gastric Bypass. OBES SURG 20, 181–187 (2010). https://doi.org/10.1007/s11695-009-9916-5
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DOI: https://doi.org/10.1007/s11695-009-9916-5