Changes of body composition in patients with BMI 23-50 after tailored one anastomosis gastric bypass (BAGUA): influence of diabetes and metabolic syndrome

The use of bariatric surgery to treat diabetes mellitus (DM) requires procedures developed for morbid obese in patients with normal and over-weight. Therefore, we started tailoring one anastomosis gastric bypass (BAGUA) adapted to each patient. This study analyzes changes in body composition (BC) of patients with BMI 23–50 after BAGUA as well as influence of DM and MS. We studied 79 (37 diabetic and 42 non-diabetic) patients (BMI 23–50) who completed all evaluation appointment (preoperative, 10 days, 1, 3, 6, and 12 months) after tailored BAGUA for obesity, diabetes, or diabesity. Patients were classified according to BMI (23–29, 30–34, 35–50) and bearing or not diabetes. Variables are components of BC as well as DM and MS. Preoperatively, mean values of weight varied 37 kg (78–115 kg), muscle mass (MM) 8 kg (54–62 kg), while fat mass (FM) 30 kg (22–53 kg). Basal metabolism (BM) was higher in diabetic. After surgery, percentage (%) of excess weight loss (%EWL) ranged from 76 % (BMI 35–50) to 128 % (BMI 23–29), FM 56 % (BMI 23–29) to 65 % (BMI 35–50), without differences bearing DM. MM 12 % (non-diabetics BMI 30–34) to 17 % (diabetics BMI 35–50) and visceral fat (VF) 50 % (diabetics BMI 30–34) to 56 % (non-diabetics BMI 35–50). After tailored BAGUA, MM maintains steady while FM is highly reduced and variable. BM is reduced in all groups. Diabetics lose less weight and VF but more MM than non-diabetic patients. Preoperative presence of MS influences the changes in BC.