Body Composition Differences Between Excess Weight Loss ≥ 50% and < 50% at 12 Months Following Bariatric Surgery
Open accessAbstract
Background The relationship between weight loss and body composition is undefined after bariatric surgery. The objective of this study was to compare body composition changes in patients with excess weight loss ≥ 50% (EWL ≥ 50) and < 50% at 12 months post-operatively (EWL < 50). Methods A prospective cohort study was completed on patients undergoing bariatric surgery at two tertiary hospitals between 2017 and 2021. Body composition was measured with dual-energy X-ray absorptiometry immediately before surgery, and at 1, 6, and 12 months post-operatively. Body mass index (BMI), fat mass (FM), lean body mass (LBM), and skeletal muscle index (SMI) trajectories were analysed between patients with EWL ≥ 50% and EWL < 50%. Results Thirty-seven patients were included in this series (EWL ≥ 50% n = 25, EWL < 50% n = 12), comprising of both primary and revisional bariatric surgery cases, undergoing a sleeve gastrectomy (62.2%), Roux-en-Y gastric bypass (32.4%), or one anastomosis gastric bypass (5.4%). The EWL ≥ 50% group demonstrated a more optimal mean FM-to-LBM loss ratio than the EWL < 50% group. EWL ≥ 50% patients lost 2.0 kg more FM than EWL < 50% patients for each 1 kg of LBM lost. EWL ≥ 50% was also associated with an increase in mean SMI% over 12 months (5.5 vs. 2.4%; p < 0.0009). Across the whole cohort, the first month after surgery accounted for 67.4% of the total LBM reduction that occurred during the 12-month post-operative period. Conclusion This data suggests EWL ≥ 50% is associated with a more optimal body composition outcome than EWL < 50%. LBM reduction occurs predominantly in the early post-operative period.
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Even at higher weight reduction tertiles (>25.9 kg), the results remained comparable with those reported in patients who achieved overlapping degrees of total body weight reduction after bariatric surgery.
“Even at higher weight reduction tertiles (>25.9 kg), our results remained comparable with those reported in patients who achieved overlapping degrees of total body weight reduction after bariatric surgery.”
From Body composition changes during weight reduction with tirzepatide in the <scp>SURMOUNT</scp> ‐1 study of adults with obesity or overweight (2025) · cites this paper as [35]
The Results (page unavailable) report weight loss after bariatric surgery, including a mean BMI reduction of 10.7 kg/m² at 12 months. Our copy does not give a weight-loss amount in kilograms that establishes overlap with the citing study’s >25.9 kg tertile. The statement that the citing authors’ results were comparable is their own comparison, not a finding attributed to this source. (LLM, conf=0.79)
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- Authors
- Sivakumar, J., Chen, Q., Sutherland, T. R., Read, M., Ward, S., Chong, L., & Hii, M. W.
- Affiliations
- The University of Melbourne (AU)
- St Vincent's Hospital Melbourne (AU)
- Corresponding author
- Sivakumar, Jonathan
- ORCID
- Venue
- Obesity Surgery
- Published
- 2022-06-01
- Volume
- 32
- Issue
- 8
- Pages
- 2556-2566
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- PMC
- PMC9156838
- OpenAlex
- W4282038122
- Cited by
- 16
- References
- 57
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 1
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Obesity Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- bariatric surgery, excess weight loss
- MeSH terms
- Body Composition, Gastrectomy, Humans, Obesity, Morbid, Prospective Studies, Retrospective Studies, Gastric Bypass, Weight Loss, Body Mass Index, Treatment Outcome, Bariatric Surgery
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