The effectiveness of low carbohydrate and energy diets at achieving weight loss following bariatric surgery: A literature review

Abstract

Obesity is a significant health burden associated with significant morbidity and mortality. Bariatric Surgery (BS) is considered as the most effective surgical intervention for treating and managing morbid obesity, as compared to other non-surgical interventions. BS surgery has been found to prolong weight loss, improve and/or resolute the co-morbidities such as diabetes, and improved quality of life. Despite several benefits of the BS, some of the patients fail to reduce their body weight for a longer duration and are recommended to follow diets including low carbohydrates / low-calorie content for maintaining or lose weight. To date, the effectiveness of such diets is still controversial. This research aims to examine the use and effectiveness of low-carbohydrate and energy diets following bariatric surgery. A literature search conducted to identify the effectiveness of low-carbohydrate and energy diets on weight loss after BS. The electronic databases used were PubMed, Scopus and Google Scholar. These databases were selected because of their accessibility and the availability of relevant and high-quality research studies. Thirteen studies were identified based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The results indicated that consumption of low carbohydrate and low-glycaemic-load diets post BS contributed to weight loss; however, evidence regarding calorie intake after long term BS and weight loss is lacking. Furthermore, several additional factors have also affected weight loss after BS, including BMI levels at the baseline, age at the time of surgery, intake of poor diet quality, lack of nutritional counselling, sedentary lifestyle. Taken together, these findings suggest a benefit role for low-carbohydrate diet in promoting weight loss. However, more studies are needed to investigate the effectiveness of low carbohydrate and energy diet for post BS patients as to help to gain a greater degree of accuracy on this matter. This review may help clinical practitioners to advice long term post bariatric patients to prevent weight gain by following low carbohydrate diet and continue the follow up sessions after surgery to avoid complications and revisional surgeries.