Paired editorial: Inadequate protein intake following laparoscopic sleeve gastrectomy surgery is associated with a greater fat free mass loss

摘要

Rapid weight loss and associated resolution of obesity-related disease are major benefits for those who undergo bariatric surgery. However, about 25% of patients do not achieve sufficient weight loss following surgery or experience weight regain [1-3]. The unfavorable physical, metabolic, and psychological outcomes of weight regain after bariatric surgery diminish the effectiveness and cost-effectiveness of the various procedures [3,4]. Sleeve gastrectomy is currently very popular [5], but weight regain may be a significant issue. A recent systematic review reported proportions of weight loss regained ranging from 6% at 2 years to 76% at 6 years postsurgery [6]. The reasons for weight regain after surgery relate to lowering of resting energy expenditure and lack of appetite control. Resting energy expenditure is reduced as consequence of a decrease in lean body mass, which is highly metabolic [7]. Immediately after surgery, many patients experience a decrease in appetite, but this phenomenon is transient, and appetitive signals may be restored or enhanced over the long-term after the procedure [8]. Strategies for maintaining lean body mass and promoting appetite control should be important goals for successful weight management after sleeve gastrectomy and other bariatric surgeries.