A Study on the Standards of Medical-Nutritional-Education by the Type of Bariatric Surgery in Morbid-obesity Patients

ABSTRACT

This study examined the effects of postoperative medical nutrition therapy on patients who had undergone bariatric surgery. Eighty seven patients who underwent bariatic-surgery at Yeouido St. Mary's Hospital from January 2007 to April 2009 were evaluated. The bariatric surgery patients included 42 Laparoscopic Roux-en Y gastric bypass (LRYGB) and 45 Laparoscopic adjustable gastric banding (LAGB) patients. Weight loss was more significant after LRYGB than after LAGB after 9 months (p<0.05). The LRYGB group was more satisfied with the weight loss (LRYGB 4.4/5.0, LAGB 3.0/5.0 p<0.001). The mean albumin, hemoglobin and hematocrit levels were significantly lower in the LRYGB group than in the LAGB group at the time of discharge (p<0.05~0.001). The GOT/GPT was significantly higher in the LRYGB group at the time of the operation than the LAGB group (p<0.01). The LRYGB group showed significantly lower intakes of total energy, carbohydrates, protein and fat from 1 week after surgery than the LAGB group. Multiple regression showed that the weight change after LRYGB was significantly more associated with the intakes of total energy at 1 week after surgery (p<0.01), SWS (sweets and high-calorie beverages) at 1 and 6 months after surgery (p<0.001), and fat at 3 months after surgery (p<0.01). In addition, LAGB was significantly more associated with the intakes of protein and NLS (non-liquid sweets) at 1 week after surgery (p<0.001, p<0.01), carbohydrate at 1 months after surgery (p<0.01), total energy at 3 months after surgery (p<0.001), HCL (high-calorie liquids) at 6 months after surgery (p<0.05), and fat at 9 months after surgery (p<0.01). These results suggest that continuous-follow-up medical nutrition therapy is needed according to the types of bariatric surgery, particularly during the weight loss phase (the first 1 week to 12 months).