Obesity
Conditions
Keywords
Obesity, Bariatric surgery, skeletal muscle, adipose tissue, weight loss
Brief summary
Objectives The objective of this project is to generate pilot data substantiating our hypothesis that advanced body composition measurement tools will provide more accurate and clinically relevant data on the outcomes of metabolic surgery (MS) in patients with severe obesity compared to traditional methods. To achieve this objective, the investigators propose the following aims: Aim 1: Evaluate the effectiveness of different body composition measurement tools in assessing outcomes in patients with severe obesity undergoing MS. Aim 2: Assess the changes in body composition and muscle strength following MS. Aim 3: Compare body compositions changes between SG and RYGB patients.
Detailed description
Background Metabolic surgery (MS) is the most effective long term obesity treatment in patients with severe obesity. The prevalence of obesity among US adults is 40.3% and the prevalence of severe obesity is 9.4% (2021-2023). Despite the prevalence and severity of obesity, there is a significant knowledge gap regarding the most effective tools for assessing body composition in this population. Traditional methods such as BMI and waist circumference may not accurately reflect changes in body composition, particularly in patients with higher BMI. Current literature on body composition measurements in patients with severe obesity undergoing bariatric surgery is limited. Our study design and rationale are inspired by a 2003 study by Das et al., which assessed body composition using four measurement tools: the 3-compartment (3C) model, isotope dilution, densitometry, and BIA. This study involved 20 women with BMIs ranging from 37 to 76 who underwent RYGB. The findings indicated that a simple 3-compartment model using air displacement plethysmography and BIA is effective for clinical evaluation in this population. To date, this remains the only study focusing on higher BMI patients undergoing MS. However, its limitations include being conducted solely on a female population and using these four measurement tools exclusively in RYGB patients with severe obesity. As mentioned earlier, the goal of this project is to generate pilot data substantiating our hypothesis that advanced body composition measurement tools will provide more accurate and clinically relevant data on the outcomes of MS in patients with severe obesity compared to traditional methods. Objectives The objective of this project is to generate pilot data substantiating our hypothesis that advanced body composition measurement tools will provide more accurate and clinically relevant data on the outcomes of metabolic surgery (MS) in patients with severe obesity compared to traditional methods. To achieve this objective, the investigators propose the following aims: Aim 1: Evaluate the effectiveness of different body composition measurement tools in assessing outcomes in patients with severe obesity undergoing MS. The investigators hypothesize that advanced body composition measurement tools will provide more accurate and clinically relevant data on the outcomes of MS in patients with severe obesity compared to traditional methods. Aim 2: Assess the changes in body composition and muscle strength following MS. The investigators hypothesize that 6 months post MS, patients will experience a change in muscle strength, along with a more significant decrease in fat mass compared to muscle mass. Aim 3: Compare body compositions changes between SG and RYGB patients. The investigators hypothesize that RYGB patients will experience greater changes in subcutaneous, visceral, and total fat compared to SG patients after 6 months.
Interventions
None listed
Sponsors
Pennington Biomedical Research Center
Our Lady of the Lake Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Being either male or female * Being an adult greater or equal to 18 years of age * BMI ≥40 kg/m2 * Weigh less than 440 pounds * Being willing to comply with the study procedures * Being scheduled for primary metabolic surgery (either Sleeve Gastrectomy or Roux-en-Y Gastric bypass)
Exclusion criteria
* Previous bariatric surgery or other complex abdominal surgery * Poorly controlled medical or psychiatric disorders * For women in child-bearing ages, being pregnant or attempting to become pregnant or currently breastfeeding * Having metal-containing objects in their body that may cause artifact on MRI * Having medical implants such as a pacemaker or metal joint replacements * Having a body weight greater than 440 pounds * Comorbid conditions that may affect body composition measurements, such as advanced liver disease or severe cardiovascular disease. * Cannot understand risks, benefits, and compliance required to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the effectiveness of Bioimpedance Analysis (BIA) in assessing outcomes in patients with severe obesity undergoing metabolic surgery (MS). | Baseline and 6 months | Measurement of weight in kilograms |
| Evaluate the effectiveness of Leg Strength and Endurance Testing in assessing outcomes in patients with severe obesity undergoing MS. | Baseline and 6 months | Leg muscle strength measured in in Newton-meters (Nm) |
| Evaluate the effectiveness of BIA in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | height in meters |
| Evaluate the effectiveness Body MRI in assessing outcomes of body composition in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Measure skeletal muscle mass volume in cm\^3 |
| Evaluate the effectiveness of anthropometric measurement tool in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Measure waist circumference in cm |
| Evaluate the effectiveness of BIA measurement tool in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | weight and height will be combined to report BMI in kg/m\^2 |
| Evaluate the effectiveness of anthropometric measurement tools in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Hip circumference in cm |
| Evaluate the effectiveness of Six-Minute Walk testing in assessing outcomes in patients with severe obesity undergoing MS. | Baseline and 6 months | Physical endurance will be measured by the distance walked during a 6-minute walk test in meter |
| Evaluate the effectiveness of 3D Optical Imaging in assessing outcomes in patients with severe obesity undergoing MS. | Baseline and 6 months | Measure body volume in cm\^3 |
| Evaluate the effectiveness of BodPod (Air Displacement Plethysmography) in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Measure body volume in liters |
| Evaluate the effectiveness of BodPod in assessing outcomes in patients with severe obesity undergoing MS. | Baseline and 6 months | Measure body density in kilograms per cubic meter (kg/m\^3) |
| Evaluate the effectiveness of Dual Energy X ray Absorptiometry (DXA) in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Measure total fat mass in kg |
| Evaluate the effectiveness of DXA in assessing outcomes in patients with severe obesity undergoing MS | Baseline and 6 months | Measure lean mass /fat free mass in kg |
| Evaluate the effectiveness of Deuterium & Bromide Dilution in assessing outcomes in patients with severe obesity undergoing metabolic surgery (MS). | Baseline and 6 months | Measure total body water in liter |
| Evaluate the effectiveness of Deuterium & Bromide Dilution in assessing outcomes in patients with severe obesity undergoing MS. | Baseline and 6 months | Measure extracellular water in liters |
Countries
United States
Contacts
CONTACTZubaidah Nor Hanipah, MD
Outcome results
None listed