A Very Low-Calorie Ketogenic Diet Approach for Post-Bariatric Weight Regain: A Pilot Study

Ilaria Ernesti, Mikiko Watanabe and Alfredo Genco ()
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Ilaria Ernesti: Department of Surgical Sciences, Sapienza University, 00161 Rome, Italy
Mikiko Watanabe: Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
Alfredo Genco: Department of Surgical Sciences, Sapienza University, 00161 Rome, Italy

J, 2024, vol. 7, issue 4, 1-7

Abstract: Weight regain (WR) after bariatric surgery, particularly sleeve gastrectomy, is a significant challenge, often driven by a combination of metabolic, behavioral, and lifestyle factors. Non-surgical interventions to manage WR are critical, given the increased risks and reduced efficacy of revisional surgeries. In this context, very low-calorie ketogenic diets (VLCKDs) have gained attention for their potential to promote weight loss and improve body composition in individuals struggling with WR. This study assessed the safety and efficacy of a VLCKD in 11 patients who experienced WR following sleeve gastrectomy. Over an 8-week period, patients demonstrated a significant average weight loss of 6.3% ( p = 0.005), along with improvements in body composition, including reductions in body fat percentage ( p = 0.003) and waist circumference ( p = 0.003). Metabolic markers, such as insulin resistance (HOMA-IR), also improved significantly ( p = 0.041). Although a decrease in the glomerular filtration rate was observed ( p = 0.007), this finding is unlikely to be clinically relevant over the short term. Importantly, no major adverse events were reported, with only mild constipation observed. These results suggest that VLCKDs may be a promising non-surgical approach for managing WR post-bariatric surgery, though further studies are needed to assess long-term effects, especially on renal function.

Keywords: sleeve gastrectomy; very low-carbohydrate diet; body composition; insulin resistance; kidney function; weight loss; obesity; complications (search for similar items in EconPapers)
JEL-codes: I1 I10 I12 I13 I14 I18 I19 (search for similar items in EconPapers)
Date: 2024
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