Dietary Intake and Weight Changes 5 Years After Laparoscopic
Published online: 6 June 2017
Springer Science+Business Media New York 2017
Background Laparoscopic sleeve gastrectomy (LSG) is be-
coming a leading primary bariatric surgery but long-term out-
come remains unclear. The amount of food eaten is drastically
reduced after LSG and may lead to nutritional deficiencies
potentially. The aim of this study is to investigate long-term
dietary intake and weight status after LSG.
Methods Forty patients underwent LSG had more than 5-year
follow-up with complete clinical data and food frequency
questionnaires were analyzed.
Results The mean age of subjects is 33.5 years old with mean
body mass index (BMI) 37.9 kg/m
. Mean BMI loss at 5 years
after LSG is 10.6 kg/m
. Weight regain appeared in 20% of
patients. Dietary composition analysis at 5 years showed mean
calorie intake of 1230 kcal/day, protein 70 g/day (22.5% of
calorie), fat 50 g/day (36.1%), carbohydrate 126 g (41.4%),
iron 7.5 mg/day, calcium 536.2 mg/day, and fiber 11.7 g/day.
Calorie intake at 5 years after LSG is correlated with weight
loss but weight regain is not related to a higher calorie intake.
All comorbidities were significantly improved after LSG but
hemoglobin and parathyroid hormone significantly changed.
Incidence of iron deficiency anemia increased from 7.5% at
pre-operation to 41.2% after LSG. Incidence of secondary
hyperparathyroidism increased from 17.5 to 60.7%.
Conclusion LSG is an effective and durable bariatric proce-
dure but with significant changes in nutritional status. Dietary
instruction for LSG should include foods rich in protein, iron,
calcium, and fiber.
Keywords Morbid obesity
Laparoscopic sleeve gastrectomy
Bariatric surgery remains a suitable intervention for patients
with morbid obesity . It improves obesity-related compli-
cations by reducing excessive body weight, recovering body
functions, and reducing the mortality rate . Among various
bariatric surgical procedures, laparoscopic sleeve gastrectomy
(LSG) has become the most commonly performed bariatric
procedure recently . LSG can facilitate percent of excess
weight loss (%EWL) by more than 72% 12 months after sur-
gery and significantly reduce the waist circumference .
However, the postoperative daily energy intake after 3 months
is only approximately 700 kcal, which is increased to 918 kcal
12 months after surgery . Such a low energy intake indi-
cates that postoperative patients need a more detailed dietary
plan and dietary supplements to receive adequate nutrition.
A successful bariatric surgery is defined as 50–70% EWL
and 20–30% loss of initial weight while achieving BMI
. On the contrary, failure in terms of weight out-
comes is described as <50% EWL, <20% loss of initial
weight, and BMI ≥35 kg/m
.About20–30% of patients with
bariatric surgery do not achieve Bsuccessful^ weight outcomes
* Shwu-Huey Yang
School of Nutrition and Health Sciences, Taipei Medical University,
No 250, Wuxing St, Xinyi District, Taipei 110, Taiwan
Central Clinic and Hospital, Taipei, Taiwan
Min-Sheng General Hospital, Taoyuan City, Taiwan
Department of Surgery, College of Medicine, Taif University,
Taif, Saudi Arabia
Nutrition Research Center, Taipei Medical University Hospital,
OBES SURG (2017) 27:3240–3246