Evidence mapPaperPMID 39227457Full record

Observational studyInternational journal of obesity (2005)2024

Metabolic adaptation following gastric bypass surgery: results from a 2-year observational study.

Fathimath Naseer, Shu-Dong Zhang, Alexander D Miras, Tamsyn Redpath, Melanie Martin, Adele Boyd, Heather Spence, Dimitri J Pournaras, Zsolt Bodnar, David Kerrigan and 3 more

Abstract readObservational Study
In one paragraph

Observational study in International journal of obesity (2005), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Nasal breathing: a neglected factor in metabolic regulation?European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Fathimath NaseerNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.
Shu-Dong ZhangSchool of Medicine, Ulster University, Londonderry, BT48 7JL, United Kingdom.ORCID 0000-0002-7721-0167
Alexander D MirasSchool of Medicine, Ulster University, Londonderry, BT48 7JL, United Kingdom.ORCID 0000-0003-3830-3173
Tamsyn RedpathNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.
Melanie MartinNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.
Adele BoydNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.
Heather SpenceNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.ORCID 0000-0001-7318-5358
Dimitri J PournarasDepartment of Bariatric and Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, England.
Zsolt BodnarDepartment of Surgery, Letterkenny University Hospital, Donegal, Ireland.
David KerriganPhoenix Health, 17E-F Telford Court, Chester, CH1 6LT, England.
Carel W le RouxDiabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.ORCID 0000-0001-5521-5445
M Barbara E LivingstoneNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom.
Ruth K PriceNutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, BT52 1SA, United Kingdom. rk.price@ulster.ac.uk.ORCID 0000-0001-8765-2842

Funding

Medical Research Council MC_PC_16017NIDDK NIH HHS R01 DK106112
6 · The paper itself

Abstract

BACKGROUND/

objectivesMetabolic adaptation is the lowering of basal metabolic rate (BMR) beyond what is predicted from changes in fat mass (FM) and fat-free mass (FFM) and may hamper weight-loss progression. It is unclear whether metabolic adaptation occurs following gastric bypass surgery (GBP) and if it persists. The aim of this study was to evaluate the reduction in BMR that is not explained by changes in body composition in patients following GBP compared to a weight-stable comparator group. SUBJECTS: Thirty-one patients [77.4% female; mean BMI 45.5(SD 7.0) kg/m

methodsBMR was measured under standardised residential conditions using indirect calorimetry and body composition using DXA. Linear regression analyses assessed metabolic adaptation post-surgery.

resultsAfter surgery, patients lost a quarter of their body weight [-25.6%(1.8%); p < 0.0001] consisting mainly of FM (4:1 FM to FFM loss ratio) at 24-months post-surgery. Absolute BMR (MJ/d) reduced by 25.7% at 24-months post-surgery with values becoming similar to the comparator group from 3-months post-surgery. Positive associations were observed between changes in BMR and changes in FFM and FM (P < 0.03). Metabolic adaptation was present in patients during the 1) rapid weight loss phase (6.9 kg/month at 3-months post-surgery) (p = 0.011), 2) slower weight loss phase (1.6 kg/month from 3 to 12-months post-surgery) (p < 0.0001), and, 3) weight maintenance phase (24-months post-surgery) (p = 0.00073). However, the degree of metabolic adaptation observed in GBP patients was similar to the weight-stable comparator group (no metabolic adaptation) from 12-months post-surgery onwards (3-months; p = 0.01, 12-months; p = 0.26, 24-months post-surgery; p = 0.70).

conclusionThese results suggest that there is a potential biological mechanism of surgery that attenuates the expected postoperative downregulation in BMR thus helping GBP patients maintain weight loss.

Indexed as

Adaptation, PhysiologicalBasal MetabolismBody CompositionGastric BypassWeight LossAdultFemaleHumansMaleMiddle AgedObesity, Morbid

Identifiers

PMID39227457
PMCPMC11502489

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.