Evolution of the basal metabolic rate after Roux-en-Y gastric bypass: a systematic review and meta-analysis

Patients who undergo Roux-en-Y gastric bypass (RYGB) exhibit a reduction in total basal metabolic rate (BMR) after surgery, which seems to be intimately related to the amount of postoperative weight loss. The objective was to perform a systematic review and meta-analysis of the literature to determine and evaluate BMR changes after RYGB. The search was performed in certified databases, and the strategy was structured according to the PRISMA ScR. The quality evaluation of the articles included in this review was assessed with two different bias risk tools (ROBINS-I and NIH) according to each study design. Two meta-analyses were elaborated based on the results. 163 articles were selected (from 2016 to 2020), and 9 articles met the inclusion criteria. All of the selected studies evaluated only adult patients, mostly women. Postoperative BMR diminished in all of the included studies after surgery compared to preoperative values. The follow-up periods were 6, 12, 24 and 36 months. Eight articles were used for the meta-analysis after the quality assessment, a total of 434 participants. Compared to baseline values, mean postoperative reductions of 356.66 kcal/d after 6 months (p < 0.001) and 432.89 kcal/d (p < 0.001) after 1 year were observed. The BMR decreases during the first years after Roux-en-Y gastric bypass, especially during the first year postsurgery.

Automated summary

Patients who undergo Roux-en-Y gastric bypass (RYGB) experience a decrease in basal metabolic rate (BMR) after surgery, especially during the first year. A systematic review and meta-analysis of 9 selected studies showed that postoperative BMR decreased compared to preoperative values. The reductions were significant at 6 months (p < 0.001) and 1 year (p < 0.001) after surgery, with average reductions of 356.66 kcal/d and 432.89 kcal/d, respectively.