Effectiveness of a Modified Cost-Effective Dietary Plan in Promoting Weight Loss and Preservation of Lean Body Mass in Patients After Bariatric Surgery
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Low-Cost Post-Bariatric Diet, Standard High-cost Post-Bariatric Diet.
- Who it may be relevant to
- Registry conditions: Obesity, Bariatric Surgery, Nutritional Status, Body Composition. Basic parameters: 18 years — 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
This study will see if a low-cost dietary plan, based on the standard dietary guidelines of the American Society for Metabolic and Bariatric Surgery (ASMBS) and using locally available foods, can help patients lose weight and keep their lean body mass after bariatric surgery. It will also check if this plan can maintain healthy levels of important nutrients such as vitamin B12, iron, and vitamin D. Patients who have undergone bariatric surgery will be randomly assigned to follow either the low-cost diet or the regular hospital diet. Their weight, body composition, and nutrient levels will be tracked at baseline, and at 1, 3, and 6 months after surgery. The aim is to find out if this simpler, affordable diet, which follows international standards, works as well as the regular plan while being easier for low-income patients to follow.
Detailed description
Obesity is a growing global health problem and is recognized by the World Health Organization (WHO) as a leading cause of preventable disease. It is a complex, long-term condition influenced by multiple factors, and treatment options range from lifestyle changes to medications and surgery. Bariatric surgery is currently the most effective long-term treatment for morbid obesity. It not only helps in significant weight loss but also improves obesity-related health problems such as type II diabetes, hypertension, and obstructive sleep apnea, while improving quality of life.
Among the various surgical techniques, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one-anastomosis gastric bypass (OAGB/MGB) are the most commonly performed. However, these surgeries can lead to reduced absorption of essential nutrients because they bypass parts of the intestine where vitamins and minerals are absorbed. Nutrient deficiencies, particularly in vitamin B12, iron, and vitamin D, are common after bariatric surgery. Therefore, structured dietary management and supplementation are essential after surgery to prevent these deficiencies and preserve lean body mass (LBM).
Standard dietary recommendations from the American Society for Metabolic and Bariatric Surgery (ASMBS) suggest a gradual progression from liquids to solid foods, adequate protein intake (1.0-1.5 g/kg), and lifelong use of vitamin and mineral supplements. However, in countries like Pakistan, where 45% of the population lives below the international poverty line, the standard postoperative diet often includes costly imported supplements like whey protein, which are unaffordable and hard to access for most patients, particularly those from rural areas. This creates barriers to dietary compliance and worsens clinical outcomes.
Adequate protein intake plays a key role in preserving lean body mass and improving recovery after bariatric surgery. Nutritional deficiencies, particularly in vitamin B12, iron, and vitamin D, remain prevalent after bariatric surgery and require targeted nutritional strategies.
In response to these challenges, this study introduces a low-cost dietary plan based on ASMBS guidelines using locally available, affordable foods to meet protein and micronutrient needs. It aims to compare this plan with the conventional high-cost hospital diet to determine whether it can effectively promote weight loss, maintain lean body mass, and prevent micronutrient deficiencies. By aligning with international standards while addressing local socioeconomic constraints, this approach could improve patient adherence, nutritional outcomes, and overall recovery following bariatric surgery.
Interventions
- Dietary supplement Low-Cost Post-Bariatric Diet
Low-Cost Post-Bariatric Diet (Experimental): Based on the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines. Uses affordable, locally available foods (e.g., eggs, lentils, local dairy products) to meet protein and micronutrient needs. Designed to be cost-effective and accessible for patients from low-income or rural areas. - Dietary supplement Standard High-cost Post-Bariatric Diet
Standard Post-Bariatric Diet (Active Comparator): The conventional high-cost diet currently followed at the study hospital. Includes imported or expensive protein supplements such as whey protein and cottage cheese, along with nutritional products not easily accessible in rural or low-resource settings.
Primary outcome measures
- Weight Loss [Time frame: Baseline, 1 month, 3 months, and 6 months after surgery.]
Secondary outcome measures (5)
- Change in Serum Iron Levels [Time frame: Baseline, 1 month, 3 months, and 6 months post-surgery.]
- Change in Serum Vitamin B12 Levels [Time frame: Baseline, 1 month, 3 months, and 6 months post-surgery.]
- Change in Serum Vitamin D Levels [Time frame: Baseline, 1 months, 3 months, and 6 months post-surgery.]
- Lean Body Mass (LBM) [Time frame: Baseline, 1 month, 3 months, and 6 months postoperatively]
- Body Mass Index (BMI) [Time frame: Baseline, 1 month, 3 months, and 6 months postoperatively]
Eligibility criteria
Inclusion criteria
- Able to give informed written consent
- Adults between the ages of 18 and 65 undergoing primary bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy, or OAGB)
Exclusion criteria
- Patients having revision bariatric surgery
- Patients with recognized diseases related to micronutrient supplementation
- Patients with pre-existing gastrointestinal, metabolic, or endocrine disorders that impair nutrient absorption
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Pakistan · 1 center
- Khyber Teaching Hospital — Peshawar
Publications
- Via MA, Mechanick JI. Nutritional and Micronutrient Care of Bariatric Surgery Patients: Current Evidence Update. Curr Obes Rep. 2017 Sep;6(3):286-296. doi: 10.1007/s13679-017-0271-x. PMID 28718091
Identifiers
NCT: NCT07111767 · 661/DME/KMC