Journal
OBESITY
Volume 15, Issue 5, Pages 1187-1198Publisher
NORTH AMER ASSOC STUDY OBESITY
DOI: 10.1038/oby.2007.639
Keywords
gastric band; fat-free mass; DXA; nitrogen; potassium
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Objective: To assess changes in body composition with weight loss in obese subjects randomized to a iaparoscopic adjustable gastric band surgical program or a medical program using a very-low-energy diet and orlistat. Research Methods and Procedures: Using body composition measurements by DXA, neutron activation for total body nitrogen. and whole body gamma counting for total body potassium. we studied changes in fat mass, fat distribution, fat-free mass, total bone mineral content, total body protein, and body cell mass at 6 (n = 61 paired) and 24 months (n = 53 paired) after randomization. Results: At 24 months. the surgical group had lost significantly more weight (surgical, 20.3 +/- 6.5 kc,; medical, 5.9 +/- 8.0 kg). There was favorable fat-free mass to fat mass loss ratios for both groups (surgical, 1:5.5; medical, 1:5.9). Changes in total body nitrogen or potassium were favorable in each group. A small reduction in mean bone mineral content occurred throughout the study but was not associated with extent of weight loss or treatment group. At 6 months, weight loss for both groups was similar (surgical, 14.1 +/- 4.5 kg; medical, 13.3 +/- 7.3 kg). The medical program subjects lost less fat-free mass and skeletal muscle and had increased total body protein. The proportion of body fat to limb fat remained remarkably constant throughout the study. Discussion: Weight loss programs used in this study induced fat loss without significant deleterious effects on the components of fat-free mass.
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