Weight Loss Via Bariatric Surgery and Lifestyle Modification

Study Overview
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Brief Summary
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Gastric myoelectric, inflammatory, and hormonal responses, body compositional, energy expenditure, and metabolic changes during the development of obesity and the weight loss process are underinvestigated. This project studied the myoelectrical inflammatory and hormonal responses of the stomach, in addition to energy expenditure and body composition changes during weight loss via bariatric surgery and lifestyle intervention.

Detailed Description
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Gastric myoelectric, inflammatory, and hormonal responses, body compositional, energy expenditure, and metabolic changes during the development of obesity and the weight loss process are underinvestigated. This project studied the myoelectrical, inflammatory, and hormonal responses of the stomach, in addition to energy expenditure and body composition changes during weight loss via bariatric surgery and lifestyle intervention. Methods: We recruited 79 participants who were assigned to three groups: bariatric surgery (BS group n=27), lifestyle intervention (LS group, n=22), and waitlist control (C group n=30). For all participants, electrogastrography, inflammatory cytokines, gastric hormones analysis, body composition analysis, energy expenditure, and dietary assessment were done at baseline and at 6 months.

Official Title
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Gastric Myoelectric Activity, Inflammatory, Dietary, and Body Composition Changes During Weight Loss Via Bariatric Surgery and Lifestyle Modification

Conditions
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Obesity, Weight Loss

Intervention / Treatment
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* Procedure: Sleeve gastrectomy
* Dietary Supplement: Lifestyle intervention
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: BMI > 35 kg/m2, Being free of any acute medical condition, inflammatory conditions, malignancy, or psychiatric disorders Exclusion Criteria: Taking weight-losing pharmacotherapy Who underwent previous bariatric surgery

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Waitlist control<br>Waitlist control (C group n=30) did not achieve any significant weight loss and did not follow lifestyle intervention | Other: Control<br>* No interventions were applied<br>|
| Lifestyle intervention<br>Lifestyle intervention (LS group, n=22) follows multimodal lifestyle intervention in form of 500-100 kcal deficit , gradual physical activity and some behavioral modifications | Dietary Supplement: Lifestyle intervention<br>* balanced 500 to 1000-calorie-deficit diet, personalized physical activity plan, and customized behavioral modification<br>|
| Bariatric surgery<br>Bariatric surgery (BS group n=27) undergoes laparoscopic sleeve gastrectomy | Procedure: Sleeve gastrectomy<br>* laparoscopic sleeve gastrectomy was done under general anesthesia by the same surgeon in the SBAHC. Routine preoperative, and postoperative care (including early post-operative dietary management) were done. Baseline assessment was taken within the last week before the surgery during the preoperative preparation and the final assessment was recorded 6 months after the surgery date.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gastric myoelectric activity | The gastric myoelectric activity was measured in fasting (for 10 mins) and post-prandial state (for 30 mins) using a multichannel electrogastrography (EGG) with a water load satiety test | 6 months | 
| Inflammatory changes | Serum levels of inflammatory markers involving interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and monocyte chemoattractant protein (MCP-1), | 6 months | 
| Body composition measurement | Body composition was analyzed via a multi-Frequency segmental bioelectric impedance analysis monitor | 6 MONTHS | 
| Resting Energy Expenditure | Resting metabolic rate (RMR) was measured by the automated metabolic cart indirect calorimetry (IC) using a standard canopy hood | 6 MONTHS | 
| hormonal analysis | serum levels of ghrelin, gastrin, and irisin (ELISA kits MyBiosource, San Diego, CA, USA; Catalog numbers: MBS2700428, MBS264399, MBS2600406, respectively). | 6 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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gastric myoelectric activity, Inflammatory, bariatric surgery, lifestyle intervention, weight loss, body composition