SEARCHCOHORTclinical nutrition, surgery

cohort·clinical nutrition, surgery, endocrinology, internal medicine, nutrition·PMC10371952

Efficacy, feasibility and tolerability of ketogenic diet for the treatment of poor response to bariatric surgery

Journal of Endocrinological Investigation · 9 authors, 6 centres

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A real-life prospective study was conducted among 22 non-diabetic adult patients (mean age 50.3 years, mean BMI 37.5 kg/m²) who experienced poor response—insufficient weight loss (IWL) or weight regain (WR)—after bariatric surgery (sleeve gastrectomy or mini-gastric bypass), occurring nearly 6 years post-surgery. No significant changes in kidney or liver function, vitamins, or iron status were detected, and no significant side effects were reported.

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cohort

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clinical nutrition

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ORIGINAL PAPER

PMC10371952

Efficacy, feasibility and tolerability of ketogenic diet for the treatment of poor response to bariatric surgery

Journal of Endocrinological Investigation

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ABSTRACT

Abstract Purpose Poor response to bariatric surgery, namely insufficient weight loss (IWL) or weight regain (WR), is a critical issue in the treatment of obesity. The purpose of our study was to assess the efficacy, feasibility, and tolerability of very low-calorie ketogenic diet (VLCKD) for the management of this condition. Methods A real-life prospective study was conducted on twenty-two patients who experienced poor response after bariatric surgery and followed a structured VLCKD. Anthropometric parameters, body composition, muscular strength, biochemical analyses, and nutritional behavior questionnaires were evaluated. Results A significant weight loss (mean 14.1 ± 4.8%), mostly due to fat mass, was observed during VLCKD with the preservation of muscular strength. The weight loss obtained allowed patients with IWL to reach a body weight significantly lower than that obtained at the post-bariatric surgery nadir and to report the body weight of patients with WR at the nadir observed after surgery. The significantly beneficial changes in nutritional behaviors and metabolic profiles were observed without variations in kidney and liver function, vitamins, and iron status. The nutritional regimen was well tolerated, and no significant side effects were detected. Conclusion Our data demonstrate the efficacy, feasibility, and tolerability of VLCKD in patients with poor response after bariatric surgery. Supplementary Information The online version contains supplementary material available at 10.1007/s40618-023-02034-2. Keywords: Very-low-calorie ketogenic diet, Bariatric surgery, Poor response, Insufficient weight loss, Weight regain

CITATION EXPORT

F Vinciguerra, S Longhitano, N Carrubba et al.. Efficacy, feasibility and tolerability of ketogenic diet for the treatment of poor response to bariatric surgery. Journal of Endocrinological Investigation. (2023). https://doi.org/10.1007/s40618-023-02034-2

AUTHORS

9 · 6 CENTRES

F Vinciguerra, S Longhitano, N Carrubba, L Piazza, C Di Stefano, M L Arpi, R Baratta, M Hagnäs, L Frittitta

1Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
2General and Emergency Surgery Department, Garibaldi Hospital, Catania, Italy
3Endocrinology Unit: Garibaldi Hospital, Catania, Italy
4Rovaniemi Health Center, Rovaniemi and Primary Health Care Unit, Lapland Central Hospital, Rovaniemi, Finland
5Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
6Diabetes, Obesity and Dietetic Center, Garibaldi Hospital, Catania, Italy