Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss

Abstract

Objective: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet.

Methods: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis.

Results: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants.

Conclusions: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Figure 1

Candidates for bariatric surgery admitted to the hospital medical school between July 2013 and September 2014 and the composition of the study population. * Motive not questioned; ** Diagnosis / reason for admission: n=5 incisional hernia, n=2 malnutrition, n=3 ring removal, n=1 intestinal stenosis.

Figure 2

Changes in BF and FFM in relation to weight loss (%) Note: BF, body fat; FFM, fat-free mass; WW, weight Loss.