Metabolic and Neuroendocrine Responses to Roux-en-Y Gastric Bypass. I: Energy Balance, Metabolic Changes, and Fat Loss (original) (raw)

Journal Article

X. Liu ,

1Departments of Medicine and Surgery, Divisions of Endocrinology, Diabetes and Metabolism (X.L., A.L., I.D., J.E.S.), Springfield, Massachusetts 01199

Search for other works by this author on:

A. Lagoy ,

1Departments of Medicine and Surgery, Divisions of Endocrinology, Diabetes and Metabolism (X.L., A.L., I.D., J.E.S.), Springfield, Massachusetts 01199

Search for other works by this author on:

I. Discenza ,

1Departments of Medicine and Surgery, Divisions of Endocrinology, Diabetes and Metabolism (X.L., A.L., I.D., J.E.S.), Springfield, Massachusetts 01199

Search for other works by this author on:

G. Papineau ,

4Department of Kinesiology (G.P., B.B.), University of Massachusetts, Amherst, Massachusetts 01003

Search for other works by this author on:

E. Lewis ,

3Nephrology (E.L., G.B.), Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199

Search for other works by this author on:

G. Braden ,

3Nephrology (E.L., G.B.), Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199

Search for other works by this author on:

J. Romanelli ,

2Bariatric Surgery (J.R.), Springfield, Massachusetts 01199

Search for other works by this author on:

B. Braun ,

4Department of Kinesiology (G.P., B.B.), University of Massachusetts, Amherst, Massachusetts 01003

Search for other works by this author on:

J. E. Silva

1Departments of Medicine and Surgery, Divisions of Endocrinology, Diabetes and Metabolism (X.L., A.L., I.D., J.E.S.), Springfield, Massachusetts 01199

*Address all correspondence and requests for reprints to: J. E. Silva, M.D., 107 Viscount Road, Longmeadow, Massachusetts 01106.

Search for other works by this author on:

Received:

03 January 2012

Published:

01 August 2012

Cite

X. Liu, A. Lagoy, I. Discenza, G. Papineau, E. Lewis, G. Braden, J. Romanelli, B. Braun, J. E. Silva, Metabolic and Neuroendocrine Responses to Roux-en-Y Gastric Bypass. I: Energy Balance, Metabolic Changes, and Fat Loss, The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 8, 1 August 2012, Pages E1440–E1450, https://doi.org/10.1210/jc.2012-1016
Close

Navbar Search Filter Mobile Enter search term Search

Abstract

Context:

Obesity is a major health problem. Effective treatment requires understanding the homeostatic responses to caloric restriction.

Objective:

The aim was to study Roux-en-Y gastric bypass patients longitudinally for 6 months after surgery to identify major factors modulating fat loss.

Methods:

We studied 13 patients (11 females and two males) aged 41.2 ± 2 yr. Mean body mass index was 44.6 ± 1.2 kg/m2, with 50 ± 1% body fat (58.3 kg). Selection excluded patients with confounding comorbidities or treatments.

Results:

Caloric intake was reduced 742 ± 82 kcal/d by 1 month and 450 kcal/d between 2 and 4 months postoperatively. By 6 months, relative to baseline, body mass index decreased 24.8 ± 1.1%; percentage body fat, 37.3 ± 3.2% (21.7 kg); fat free mass (FFM), 9.7 ± 1.2%; and resting metabolic rate (RMR), 18.1 ± 4.3%. RMR correlated with FFM at all times (r = 0.71; P < 0.0001), but FFM explained no more than 50% of RMR variance. Exercise capacity (treadmill walking, 53 m/min with increasing grade) improved with time. Mean nonexercise physical activity level was low (1.2, or 20% of RMR), with considerable variance among individuals. Fat loss did not correlate with the aggregate energy deficit or its individual components. Resting or postexercise respiratory exchange ratio (RER) was lowest, whereas plasma β-OH-butyrate and glycerol were highest, between 1 and 2 months after surgery. RER increased linearly with mild exercise, and fat loss correlated positively with physical activity level and RER.

Conclusions:

Although the ultimate cause for weight loss is the energy deficit, the variance in fat loss correlated with glucose oxidation, suggesting that glucose partition between oxidation (muscle) and storage (adipose tissue) is an important factor affecting fat loss in individuals submitted to Roux-en-Y gastric bypass.

Copyright © 2012 by The Endocrine Society

You do not currently have access to this article.

Personal account

Get help with access

Institutional access

Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:

IP based access

Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.

Sign in through your institution

Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution's website and Oxford Academic.

  1. Click Sign in through your institution.
  2. Select your institution from the list provided, which will take you to your institution's website to sign in.
  3. When on the institution site, please use the credentials provided by your institution. Do not use an Oxford Academic personal account.
  4. Following successful sign in, you will be returned to Oxford Academic.

If your institution is not listed or you cannot sign in to your institution's website, please contact your librarian or administrator.

Sign in with a library card

Enter your library card number to sign in. If you cannot sign in, please contact your librarian.

Society Members

Society member access to a journal is achieved in one of the following ways:

Sign in through society site

Many societies offer single sign-on between the society website and Oxford Academic. If you see "Sign in through society site" in the sign in pane within a journal:

  1. Click Sign in through society site.
  2. When on the society site, please use the credentials provided by that society. Do not use an Oxford Academic personal account.
  3. Following successful sign in, you will be returned to Oxford Academic.

If you do not have a society account or have forgotten your username or password, please contact your society.

Sign in using a personal account

Some societies use Oxford Academic personal accounts to provide access to their members. See below.

Personal account

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.

Some societies use Oxford Academic personal accounts to provide access to their members.

Viewing your signed in accounts

Click the account icon in the top right to:

Signed in but can't access content

Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.

Institutional account management

For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.

Purchase

Short-term Access

To purchase short-term access, please sign in to your personal account above.

Don't already have a personal account? Register

Metabolic and Neuroendocrine Responses to Roux-en-Y Gastric Bypass. I: Energy Balance, Metabolic Changes, and Fat Loss - 24 Hours access

EUR €39.00

GBP £33.00

USD $43.00

Rental

Read this now at DeepDyve

This article is also available for rental through DeepDyve.

Citations

Views

Altmetric

Email alerts

Citing articles via

More from Oxford Academic