ArticleObesity surgery2026
Distinct Body Composition Responses Despite Similar Total Weight Loss After Metabolic and Bariatric Surgery: A Retrospective Cohort Study.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionConventional outcomes after metabolic and bariatric surgery (MBS) do not distinguish the composition of weight lost from the body composition achieved, and their interchangeability is rarely examined, particularly in East Asian populations. We characterized the 12-month response across three domains: tissue-specific loss, achieved composition, and fat-to-fat-free balance.
methodsThis retrospective study included 276 adults (230 sleeve gastrectomy, 46 Roux-en-Y gastric bypass). Bioelectrical impedance analysis was performed preoperatively and at 3, 6, 9, and 12 months. Relative fat mass (FM) and fat-free mass (FFM) loss, 12-month fat-free mass index (FFMI), fat mass index (FMI), and FFM/FM ratio were analyzed by regression and analysis of covariance.
resultsTotal weight loss at 12 months was 28.9 ± 7.0%. Relative FM loss increased progressively (26.8% to 49.0%, 3 to 12 months), whereas most FFM loss occurred early (10.2% to 11.4%). BMI decreased from 40.5 to 28.7 kg/m² (FMI - 9.3, FFMI - 2.5) and the FFM/FM ratio increased from 1.15 to 2.17. Weight loss did not differ by sex (P = 0.358), yet men had greater relative FM loss, lower FFM loss, higher FFMI, and lower FMI (all P ≤ 0.013). The proportion of weight lost as FFM also did not differ (P = 0.289) and did not consistently reflect achieved lean reserve; 11 patients (4.0%) had low FFMI.
conclusionSimilar total weight loss can conceal distinct body-composition responses. Tissue-specific loss, achieved FFMI and FMI, and FFM/FM balance provide complementary information not captured by total weight loss or loss composition alone.
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