Scientific evidence for the updated guidelines on indications for metabolic and bariatric surgery (IFSO/ASMBS).

The 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for metabolic and bariatric surgery (MBS), replacing the previous guidelines established by the National Institutes of Health (NIH) over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams (MDTs), as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.

Show me the evidence to guide nutrition practice: Scoping review of macronutrient dietary treatments after metabolic and bariatric surgery.

Background: Clinical practice recommendations for macronutrient intake in Metabolic and Bariatric Surgery (MBS) are insufficiently grounded in the research, possibly due to a paucity of research in key areas necessary to support macronutrient recommendations. An initial scoping review, prior to any systematic review, was determined to be vital.

Objectives: To identify topical areas in macronutrients and MBS with a sufficient evidence base to guide nutrition recommendations.

Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022).

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health.

Brazilian guide to nutrition in bariatric and metabolic surgery.

Purpose: Brazilian nutrition recommendations for bariatric and metabolic surgery aim to provide knowledge, based on scientific evidence, on nutritional practices related to different surgical techniques in the surgical treatment of obesity and metabolic diseases.

Materials And Methods: A systematic literature search was carried out with the appropriate MeSH terms using Medline/Pubmed/LiLACS and the Cochrane database, with the established criteria being based on the inclusion of articles according to the degree of recommendation and strength of evidence of the Classification of Recommendations, Evaluation, Development, and Evaluation System (GRADE).

Results: The recommendations that make up this guide were gathered to assist in the individualized clinical practice of nutritionists in the nutritional management of patients with obesity, including nutritional management in the intragastric balloon; pre and postoperative nutritional treatment and supplementation in bariatric and metabolic surgeries (adolescents, adults, elderly, pregnant women, and vegetarians); hypoglycemia and reactive hyperinsulinemia; and recurrence of obesity, gut microbiota, and inflammatory bowel diseases.

2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery.

MAJOR UPDATES TO 1991 NATIONAL INSTITUTES OF HEALTH GUIDELINES FOR BARIATRIC SURGERY: Metabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m.

2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery.

Major updates to 1991 National Institutes of Health guidelines for bariatric surgery.

Gut Microbiota Modifications and Weight Regain in Morbidly Obese Women After Roux-en-Y Gastric Bypass.

Introduction: The relationship between late post-bariatric surgery weight regain and gut microbiota is not completely understood.

Objective: To analyze the profile of gut microbiota among patients with and without late weight regain after post-Roux-en-Y gastric bypass (RYGB) and to compare it with a control group (CG) comprised of obese Brazilian individuals.

Methods: This is a cross-sectional study which enrolled 34 morbidly obese women divided into 3 groups: post-Roux-en-Y gastric bypass without (RYGB_non-regain), and with weight regain (RYGB_regain) at least 5 years after surgery, and a CG of preoperative individuals.

The Optimal Nutritional Programme for Bariatric and Metabolic Surgery.

Purpose Of Review: Bariatric surgery is the most effective treatment for severe and complex obesity; however, the risk of developing nutrient deficiencies varies based upon the type of surgery, degree of malabsorption, and level of nutrition intervention. There are numerous factors that can impact the nutrition status of a patient during their pre- and postoperative journey. We review the critical components and considerations needed in order to provide optimal nutrition care for patients with bariatric surgery.

Supplementation Adherence and Outcomes Among Pregnant Women After Bariatric Surgery.

Purpose: Most patients undergoing bariatric surgery (BS) are fertile women whose postoperative (post-op) hormonal balance and weight loss increases fertility, frequently leading to pregnancy. This study aims to analyze supplementation adherence of pregnant women after BS and perinatal outcomes.

Materials And Methods: This retrospective study analyzed records from women after BS who consulted nutritionists at least twice during pregnancy.

Diet-induced thermogenesis in postoperatve Roux-en-Y gastric bypass patients with weight regain.

Background: Bariatric surgery has been shown to be an effective treatment for obesity. Changes in energy expenditure, especially through diet-induced thermogenesis (DIT), have been identified as one of the mechanisms to explain this success. However, not all patients are able to maintain healthy postoperative weight loss.

Effects of a very low calorie diet in the preoperative stage of bariatric surgery: a randomized trial.

Background: Preoperative bariatric patients can follow very low calorie diets (VLCD), reducing surgical risks. However, possible advantages of a liquid diet over one of normal consistency are controversial. This study investigated the effect of a liquid VLCD compared with one of normal consistency considering visceral fat (VF) loss and metabolic profile in preoperative clinically severe obese patients.

Comparison of weight loss, food consumption and frequency of vomiting among Roux-en-Y gastric bypass patients with or without constriction ring.

Background: After Roux-en-Y gastric bypass to avoid rapid gastric emptying, dumping syndrome and regained weight due to possible dilation of the gastric pouch, was proposed to place a ring around the gastric pouch.

Aim: To compare weight loss, consumption of macronutrients and the frequency of vomiting among patients who underwent Roux-en-Y gastric bypass with and without the placement of a constriction ring around the pouch.

Method: A retrospective study, in which an analysis of medical records was carried out, collecting data of two groups of patients: those who underwent the operation with the placement of a constriction ring (Ring Group) and those who underwent without the placement of a ring (No-Ring Group).

Diet-induced thermogenesis and respiratory quotient after Roux-en-Y gastric bypass surgery: a prospective study.

Background: Studies in humans and other animals have shown that Roux-en-Y gastric bypass (RYGB) leads to increased energy expenditure (EE). We analyzed several components of EE, such as the respiratory quotient (RQ), resting metabolic rate (RMR), and diet-induced thermogenesis (DIT) among patients before and after RYGB.

Methods: In this prospective clinical study, RMR, DIT, and RQ were measured by indirect calorimetry (IC) in the same patients before and 12 months after RYGB (the preoperative and postoperative time points, respectively).

Validation study of multi-frequency bioelectrical impedance with dual-energy X-ray absorptiometry among obese patients.

Background: Body mass index (BMI) is the most common parameter for classifying nutritional status. However, body composition (BC) may vary considerably among individuals with identical BMIs; consequently, we need to assess BC efficiently. Bariatric surgery is the most effective method for treating obesity.

Validation of ultrasound examination for assessment of the abdominal visceral fat in clinically serious obese patient.

Background: Computerized tomography is the gold-standard for measurement of abdominal visceral fat. However, it is costly and involves submitting patients to ionizing radiation.

Aim: To validate the use of ultrasonography in assessing abdominal visceral fat among clinically serious obese patients of both genders.

Diet-induced thermogenesis and respiratory quotient after Roux-en-Y gastric bypass.

Background: Roux-en-Y gastric bypass (RYGB) surgery is an effective tool for long-term weight loss. Mechanisms underlying the effectiveness of such surgery might result not only from the anatomic changes due to the procedure, but also from favorable changes in energy metabolism. Our objective was to evaluate the respiratory quotient (RQ), resting metabolic rate (RMR), and diet-induced thermogenesis (DIT) among clinically severe obese patients (control group) and patients who had undergone RYGB ≥ 1 year previously.

Energy expenditure before and after Roux-en-Y gastric bypass.

Background: Weight loss may decrease the energy expenditure (EE) because of changes in body composition (BC). The reduction in EE may contribute, in part, to weight regain. Experimental studies in animals indicate that Roux-en-Y Gastric Bypass (RYGB) increases the resting metabolic rate (RMR) when adjusted for body weight (BW).

Metabolic profile of clinically severe obese patients.

Background: Since low basal metabolic rate (BMR) is a risk factor for weight regain, it is important to measure BMR before bariatric surgery. We aimed to evaluate the BMR among clinically severe obese patients preoperatively. We compared it with that of the control group, with predictive formulas and correlated it with body composition.

Dietary protein intake and bariatric surgery patients: a review.

Bariatric surgery, a highly successful treatment for obesity, requires adherence to special dietary recommendations to insure the achievement of weight loss goals and weight maintenance. Postoperative consumption of protein is linked to satiety induction, nutritional status, and weight loss. Hence, we conducted an extensive literature review to identify studies focused on the following: protein and nutritional status; recommendations for dietary protein intake; the effects of protein-rich diets; and associations between dietary protein intake and satiety, weight loss, and body composition.

Energy expenditure and weight regain in patients submitted to Roux-en-Y gastric bypass.

Background: Although Roux-en-Y gastric bypass (RYGBP) is a highly effective treatment for clinically severe obesity, not all patients achieve desirable weight loss and maintenance. There is some evidence that weight loss can induce a disproportionate reduction in resting metabolic rate (RMR). This reduction in RMR can be related to fat-free mass (FFM) loss, as FFM is the greatest responsible for variations in energy expenditure at rest.