Medical weight loss versus bariatric surgery: does method affect body composition and weight maintenance after 15% reduction in body weight?
OBJECTIVE
The aim of this study was to investigate body composition changes in fat mass (FM) to lean body mass (LBM) ratios following 15% body weight loss (WL) in both integrated medical treatment and bariatric surgery groups.


METHODS
Obese patients (body mass index [BMI] 46.6 ± 6.5 kg/m(2)) who underwent laparoscopic gastric bypass surgery (BS), were matched with 24 patients undergoing integrated medical and behavioral treatment (MT). The BS and MT groups were evaluated for body weight, BMI, body composition, and waist circumference (WC) at baseline and after 15% WL.


RESULTS
Following 15% body WL, there were significant decreases in %FM and increased %LBM (P < 0.0001). Additionally, both groups saw 76% of WL from FM, and 24% from LBM indicating a 3:1 ratio of FM to LBM loss during the first 15% reduction in body weight. Finally, no significant differences (P = 0.103) between groups for maintenance of WL at 1 y were found. For both groups, baseline FM was found to be negatively correlated with percentage of weight regained (%WR) at 1 y post-WL (r = -0.457; P = 0.007). Baseline WC and rate of WL to 15% were significant predictors of %WR only in the BS group (r = 0.713; P = 0.020).


CONCLUSION
If followed closely by professionals during the first 15% body WL, patients losing 15% weight by either medical or surgical treatments can attain similar FM:LBM loss ratios and can maintain WL for 1 y.
['Kulovitz|Michelle G|MG|', 'Kolkmeyer|Deborah|D|', 'Conn|Carole A|CA|', 'Cohen|Deborah A|DA|', 'Ferraro|Robert T|RT|']
D000328:Adult D000368:Aged D001823:Body Composition D015992:Body Mass Index D005260:Female D015390:Gastric Bypass D006801:Humans D010535:Laparoscopy D016014:Linear Models D008297:Male D008875:Middle Aged D009043:Motor Activity D009516:New Mexico D009765:Obesity D012189:Retrospective Studies D015431:Weight Loss
Weight loss Bariatric surgery Body composition Weight maintenance Fat mass Obesity Lean mass