4.4 Article

Effectiveness and Safety of a Very Low-Calorie Ketogenic Diet on Weight Regain Following Bariatric Surgery

Journal

OBESITY SURGERY
Volume 31, Issue 12, Pages 5383-5390

Publisher

SPRINGER
DOI: 10.1007/s11695-021-05703-4

Keywords

Very low-calorie ketogenic diet; Ketogenic diet; Bariatric surgery; Obesity; Pnk method; VLCKD

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This study evaluated the response to a very low-calorie ketogenic diet (VLCKD) in patients who did not achieve desired weight loss or experienced weight regain after bariatric surgery. The results showed significant reductions in weight, BMI, abdominal circumference, and glycated hemoglobin levels post-ketogenic diet, with no differences in certain biochemical markers. The ketogenic diet was recommended as an effective and safe treatment option for these patients.
Purpose Obesity is one of the major public health problems worldwide and bariatric surgery is considered the gold standard treatment for severe obesity. Although the literature supports the safety and efficacy of the very low-calorie ketogenic diet (VLCKD) in patients with obesity, there is no study analyzing the use in case of failure or weight regain after bariatric surgery. This work has the purpose of assessing the response to a VLCKD (Pnk (R) method) in this population. Methods We have conducted an observational, retrospective, and descriptive study with the analysis of medical charts of private offices where patients were examined between 2014 and 2019, totalizing 11 participants who underwent Roux-en-Y gastric bypass (RYGB) without a reduction of 50% in body weight excess or any weight regain after the surgery. The patients followed the first stage of a commercial weight loss program (Pnk (R) method) which consists of a VLCKD (600-800 kcal/day), low in carbohydrates and lipids. Results A significant reduction was observed (p-value < 0.05) in weight, body mass index (BMI), abdominal circumference (AC), and glycated hemoglobin (A1C) post-ketogenic diet. Uric acid, transaminases, urea, and creatinine values did not show differences between pre- and post-ketosis. During the course of the study, no serious adverse events were reported. Conclusion This study has shown that the ketogenic diet can be recommended as an effective and safe treatment for patients who progressed with insufficient weight loss or regain after bariatric surgery.

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