Journal List > J Nutr Health > v.48(1) > 1081398

J Nutr Health. 2015 Feb;48(1):30-45. Korean.
Published online February 28, 2015.  https://doi.org/10.4163/jnh.2015.48.1.30
© 2015 The Korean Nutrition Society
Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients*
Eun-Ha Jeong,1 Hong-Chan Lee,2 and Jung-Eun Yim1
1Department of Food & Nutrition, Changwon National University, Changwon, Gyeongnam 641-773, Korea.
2CHAN Bariatric Surgery Hospital, Seoul 135-887, Korea.

To whom correspondence should be addressed. Email: jeyim@changwon.ac.kr
Received September 18, 2014; Revised November 12, 2014; Accepted December 30, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss.

Methods

This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery.

Results

Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery.

Conclusion

Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

Keywords: bariatric surgery; nutrition education; severe obese patients

Figures


Fig. 1
Weight changes of preoperation and postoperation
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Tables


Table 1
Nutrition education contents
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Table 2
General characteristics of the subjects according to level of education
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Table 3
Health-related lifestyle of the subjects according to level of education
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Table 4
Obesity complications of the subjects according to level of education
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Table 5
Dietary habits of the subjects according to level of education
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Table 6
Nonoperative treatments of the subjects according to level of education
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Table 7
Body composition of the subjects according to level of education1)
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Table 8
Change of nutritional assessment index1)
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Table 9
Blood biochemical parameters in preoperation and 6 months postoperation1)
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Notes

This work was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the ministry of Education, Science and Technology (2013R1A1A3010917).

References
1. World Health Organization (CH). Obesity and overweight [Internet]. Geneva: WHO Media Centre; 2011 [cited 2014 Jun 12].
2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Cheongwon: Korea Centers for Disease Control and Prevention; 2013.
3. Heo YS, Park JM, Kim YJ, Kim SM, Park DJ, Lee SK, Han SM, Shim KW, Lee YJ, Lee JY, Kwon JW. Bariatric surgery versus conventional therapy in obese Korea patients: a multicenter retrospective cohort study. J Korean Surg Soc 2012;83(6):335–342.
4. Eckel RH. Clinical practice. Nonsurgical management of obesity in adults. N Engl J Med 2008;358(18):1941–1950.
5. Ahn BC, Joung H. Socioeconomic cost of obesity in Korea. Korean J Nutr 2005;38(9):786–792.
6. Nam S, Park J. Depression and stress related to obesity among normal, obese, and severe obese groups: comparison among normal, obesity, and severe obesity group. Korean J Hum Ecol 2012;21(6):1199–1210.
7. Wittgrove AC, Clark GW, Schubert KR. Laparoscopic Gastric Bypass, Roux-en-Y: technique and results in 75 patients with 3-30 months follow-up. Obes Surg 1996;6(6):500–504.
8. Björntorp P. Metabolic implications of body fat distribution. Diabetes Care 1991;14(12):1132–1143.
9. Kang JG, Lee CB, Lee HS, Bae SC, Choi WH. Effect of weight reduction after group therapy on the quality of life of patients with obesity. Korean J Obes 2005;14(3):149–154.
10. Hur Y. A review of bariatric surgery procedures and outcomes. Korean J Obes 2008;17(4):141–153.
11. Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab 2004;89(6):2608–2615.
12. Belle SH, Berk PD, Courcoulas AP, Flum DR, Miles CW, Mitchell JE, Pories WJ, Wolfe BM, Yanovski SZ. Longitudinal Assessment of Bariatric Surgery Consortium Writing Group. Safety and efficacy of bariatric surgery: Longitudinal Assessment of Bariatric Surgery. Surg Obes Relat Dis 2007;3(2):116–126.
13. Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232(4):515–529.
14. O'Brien PE, Brown WA, Smith A, McMurrick PJ, Stephens M. Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg 1999;86(1):113–118.
15. Belachew M, Belva PH, Desaive C. Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesity. Obes Surg 2002;12(4):564–568.
16. Allied Health Sciences Section Ad Hoc Nutrition CommitteeAills L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS allied health nutritional guidelines for the surgical weight loss patient. Surg Obes Relat Dis 2008;4 5 Suppl:S73–S108.
17. Kim DM, Ahn CW, Choi SH. Surgical treatment of morbid obesity-focusing on laparoscopic Roux-en-Y Gastric Bypass Surgery. J Korean Soc Study Obes 2004;13(2):97–100.
18. Lee H, Kim M, Kwon H, Song K, Kim E. The impact of metabolic and bariatric surgery on morbidly obese patients with type 2 DM. J Korean Surg Soc 2010;79(1):8–13.
19. Kim HJ, Namgung SA, Hong JI, Mok HJ. A study on the standards of medical-nutritional-education by the type of bariatric surgery in morbid-obesity patients. J Korean Diet Assoc 2010;16(2):178–187.
20. Drewnowski A, Popkin BM. The nutrition transition: new trends in the global diet. Nutr Rev 1997;55(2):31–43.
21. Giusti V, Suter M, Héraïef E, Gaillard RC, Burckhardt P. Effects of laparoscopic gastric banding on body composition, metabolic profile and nutritional status of obese women: 12-months follow-up. Obes Surg 2004;14(2):239–245.
22. Schindler K, Prager G, Ballaban T, Kretschmer S, Riener R, Buranyi B, Maier C, Luger A, Ludvik B. Impact of laparoscopic adjustable gastric banding on plasma ghrelin, eating behaviour and body weight. Eur J Clin Invest 2004;34(8):549–554.
23. Kim OH, Jung H, Kim JH. Comparison of food intakes and serum lipid levels in overweight and obese women by body mass index. Korean J Community Nutr 2007;12(1):40–49.
24. Suter PM. Effect of alcohol on body weight. Nutr Clin Care 2000;3(2):102–108.
25. Westerterp-Plantenga MS, Verwegen CR. The appetizing effect of an aperitif in overweight and normal-weight humans. Am J Clin Nutr 1999;69(2):205–212.
26. Bamia C, Trichopoulou A, Lenas D, Trichopoulos D. Tobacco smoking in relation to body fat mass and distribution in a general population sample. Int J Obes Relat Metab Disord 2004;28(8):1091–1096.
27. Canoy D, Wareham N, Luben R, Welch A, Bingham S, Day N, Khaw KT. Cigarette smoking and fat distribution in 21,828 British men and women: a population-based study. Obes Res 2005;13(8):1466–1475.
28. Choe JM. Dynamical trait for Korean obesity: based on data for National Health Nutrition Surveys, 1998. J Korean Soc Study Obes 2001;10(3):293–295.
29. Holty JE, Parimi N, Ballesteros M, Blackwell T, Cirangle PT, Jossart GH, Kimbrough ND, Rose JM, Stone KL, Bravata DM. Does surgically induced weight loss improve daytime sleepiness? Obes Surg 2011;21(10):1535–1545.
30. Kang JS, Kim HS. A study on the evaluation of a nutritional education program for the middle aged obese women. Korean J Food Nutr 2004;17(4):356–367.
31. Kim HK, Kim MJ. Effects of weight control program on dietary habits and blood composition in obese middle-aged women. Korean J Nutr 2010;43(3):273–284.
32. Kim MK, Lee GC. Weight reduction dieting survey and satisfaction degree and diet related knowledge among adult women by age. J Korean Soc Food Sci Nutr 2006;35(5):572–582.
33. Yoo SJ. Pharmacological treatment of obesity. J Korean Endocr Soc 2008;23(4):223–233.
34. Thompson WR, Gordon NF, Pescatello LS. American College of Sports Medicine. In: ACSM's guidelines for exercise testing and prescription. 8th edition. Philadelphia (PA): Wolters Kluwer Lippincott Williams & Wilkins; 2010.
35. Wang N, Hikida RS, Staron RS, Simoneau JA. Muscle fiber types of women after resistance training--quantitative ultrastructure and enzyme activity. Pflugers Arch 1993;424(5-6):494–502.
36. Park SK, Kim EH, Kwon YC, Park JK, Kang SY, Jang JH. Effects of combined exercise program on health-related physical fitness, anti-aging hormone and prevention of sarcopenia in elderly women with sarcopenia. J Sport Leis Stud 2010;40(1):435–442.
37. Hong JY, Oak JS. Effects of 12 weeks aerobic.anaerobic combined exercise training on fitness, body composition, skeletal muscle index and blood lipid profiles in obese elderly women. Korean J Obes 2013;22(1):30–38.
38. Park SK, Kim EH. Effects of combined training and ACE polymorphism on risk factors of metabolic syndrome in the older women. Korean J Phys Educ 2006;45(2):503–514.
39. Won HS, Lee HJ, Kwak JS, Kim J, Kim MK, Kwon O. Study on purchase and intake patterns of individuals consuming dietary formula for weight control or health/functional foods. Korean J Nutr 2012;45(6):541–551.
40. Chang KJ. Treatment of obese women with low calorie diet, aerobic exercise and behavior modification. J Korean Soc Food Nutr 1995;24(4):510–516.
41. Kenler HA, Brolin RE, Cody RP. Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr 1990;52(1):87–92.
42. Lee JH. Bariatric surgery. Korean J Med 2013;84(5):640–649.
43. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE. Abdominal adiposity and coronary heart disease in women. JAMA 1998;280(21):1843–1848.
44. Baik I, Ascherio A, Rimm EB, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Adiposity and mortality in men. Am J Epidemiol 2000;152(3):264–271.
45. Clark JM, Alkhuraishi AR, Solga SF, Alli P, Diehl AM, Magnuson TH. Roux-en-Y gastric bypass improves liver histology in patients with non-alcoholic fatty liver disease. Obes Res 2005;13(7):1180–1186.
46. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32(7):1327–1334.
47. Cummings S, Apovian CM, Khaodhiar L. Obesity surgery: evidence for diabetes prevention/management. J Am Diet Assoc 2008;108 4 Suppl 1:S40–S44.
48. Guidone C, Manco M, Valera-Mora E, Iaconelli A, Gniuli D, Mari A, Nanni G, Castagneto M, Calvani M, Mingrone G. Mechanisms of recovery from type 2 diabetes after malabsorptive bariatric surgery. Diabetes 2006;55(7):2025–2031.
49. Jung MS, Bae JH, Kim YH. Relationships between dietary intake and serum lipid profile of subjects who visited health promotion center. J Korean Soc Food Sci Nutr 2008;37(12):1583–1588.