The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass
Open accessAbstract
Background Roux-en-Y gastric bypass (RYGB) restricts food intake, and when the Roux limb is elongated to 150 cm, the procedure is believed to induce malabsorption.Objective Our objective was to measure total reduction in intestinal absorption of combustible energy after RYGB and the extent to which this was due to restriction of food intake or malabsorption of ingested macronutrients.Design Long-limb RYGB was performed in 9 severely obese patients. Dietary intake and intestinal absorption of fat, protein, carbohydrate, and combustible energy were measured before and at 2 intervals after bypass. By using coefficients of absorption to measure absorptive function, equations were developed to calculate the daily gram and kilocalorie quantities of ingested macronutrients that were not absorbed because of malabsorption or restricted food intake.Results Coefficients of fat absorption were 92 ± 1.3% before bypass, 72 ± 5.5% 5 mo after bypass, and 68 ± 8.7% 14 mo after bypass. There were no statistically significant effects of RYGB on protein or carbohydrate absorption coefficients, although protein coefficients decreased substantially in some patients. Five months after bypass, malabsorption reduced absorption of combustible energy by 124 ± 57 kcal/d, whereas restriction of food intake reduced energy absorption by 2062 ± 271 kcal/d. Fourteen months after bypass, malabsorption reduced energy absorption by 172 ± 60 kcal/d compared with 1418 ± 171 kcal/d caused by restricted food intake.Conclusion On average, malabsorption accounted for ≈6% and 11% of the total reduction in combustible energy absorption at 5 and 14 mo, respectively, after this gastric bypass procedure.
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Beneficial effects of bariatric surgery are not achieved through caloric restriction or malabsorption alone.
“While it is clear that beneficial effects of bariatric surgery are not achieved through caloric restriction or malabsorption alone [121, 122]”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [122]
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- Authors
- Odstrcil, E. A., Martinez, J. G., Santa Ana, C. A., Xue, B., Schneider, R. E., Steffer, K. J., Porter, J. L., Asplin, J., Kuhn, J. A., & Fordtran, J. S.
- Affiliations
- Baylor University Medical Center (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 92
- Issue
- 4
- Pages
- 704-713
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2158151423
- Cited by
- 209
- References
- 39
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 13 · 2022: 8 · 2021: 14 · 2020: 18 · 2019: 10 · 2018: 14 · 2017: 15 · 2016: 17 · 2015: 22 · 2014: 17 · 2013: 21 · 2012: 16
- FWCI
- 14.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- Roux-en-Y gastric bypass, malabsorption, energy absorption, dietary restriction, fat absorption, protein absorption, carbohydrate absorption, bariatric surgery, obesity, macronutrient absorption
- MeSH terms
- Adult, Barium Sulfate, Energy Intake, Diabetes Mellitus, Dietary Proteins, Duodenum, Eating, Energy Metabolism, Feces, Female, Humans, Hydrogen, Intestinal Absorption, Malabsorption Syndromes, Male, Middle Aged, Nitrogen, Obesity, Morbid, Organ Size, Respiratory Physiological Phenomena, Gastric Bypass, Body Mass Index, Urinalysis, Body Size
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