Ketogenic diet reduces body weight in patients scheduled for weight loss surgery

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Eating a ketogenic diet for four weeks encouraged weight loss and improved micronutrient deficiencies in obese patients scheduled for weight loss surgery, a study reveals. Scientists assessed the safety and success of the ketogenic diet on 27 morbidly obese people. Ketogenic diets which generally restrict carbohydrate intake to around 30g per day are very effective in lowering blood sugar levels and losing weight. They have therefore been the focus on several recent studies investigating their efficacy in treating type 2 diabetes and improving other aspects of metabolic health. All of the participants were due to undergo bariatric surgery. Dietary interventions prior to weight loss surgery are designed to reduce the size of the liver, improve the health of the organ and reduce the risk of health complicationsof surgery occurring. A low fat, very low calorie diet is the standard pre-surgery diet. This may include small quantities of whole foods or meal replacement soups or shakes. The researchers aimed to investigate whether a ketogenic diet could be more effective at reducing body weight, liver size and helping patients to comply well with the diet. They were assigned a four-week preoperative ketogenic micronutrient-enriched diet (KMED), which all participants adhered to. The Italian and French research team monitored a variety of health markers before and after the trial including body weight, BMI, size of the liver (left hepatic lobe volume), micronutrient status and metabolic patterns. There were "highly significant" decreases in body weight and reduced liver size, the researchers revealed. The participants also benefited from improved micronutrient status. Compliance in the diet was high and no adverse side effects were reported by patients, who completed questionnaires measuring diet acceptability and side effects. While the research was only a prospective pilot study, the results are useful as they demonstrate a ketogenic diet could provide an effective alternative to low fat, very low calorie pre-surgery dietary interventions. The study is published in the journal Obesity Surgery.

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bulkbiker

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Hardly surprising... but did the subjects carry on and have the surgery or just continue with the diet? I have a horrible feeling I might just know the answer..!
 
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ickihun

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I wonder why they didn't avoid their bariatric operations?
Not enough weight loss? Or enough time to lose more?

You would think it would be good enough to avoid op?
No mention of any of them reversing diabetes, just they lost weight like low calorie diets did.

I personally still want op as keto doesn't guarantee the fast weight loss the op offers and relief from obesity ailments. Asap.
That's only my personal preference.
Everyone is capable of more or less than me.

I'm ill everytime I slim. My body doesn't like the restrictions but with medical help. I should be ok.
I'm anaemic now. Yet I eat loads of eggs, meat, brussel sprout, cabbage and broccoli. Peas too.
I think my big body is used to unlimited nutrients.
I eat my 3 meals with plenty of liquids too. Sometimes a supper if bgs nearing a hypo... just until I reduce my basal.
 
ickihun

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I'm delighted with it thou.
Many will benefit from it in our WLS programme. Loads are sitting on the programme due to no weight loss on less calories.
Many would refuse op if they could constantly lose weight on their own. I'm sure of it. It's written on most of their faces, they'd prefer not to have op.... It's a last resort.
 
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Mbaker

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bulkbiker said:
Hardly surprising... but did the subjects carry on and have the surgery or just continue with the diet? I have a horrible feeling I might just know the answer..!
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When I have watched the TV show 'My 600-Lb Life', Dr. Younan Nowzaradan always encourages (insists) his patients lose significant weight with a carb restricted diet before he commits to surgery. Often the patient loses well in excess of 30 pounds, so I think why not continue on that protocol and tweak it with mental support.
 
Oldvatr

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Mbaker said:
When I have watched the TV show 'My 600-Lb Life', Dr. Younan Nowzaradan always encourages (insists) his patients lose significant weight with a carb restricted diet before he commits to surgery. Often the patient loses well in excess of 30 pounds, so I think why not continue on that protocol and tweak it with mental support.
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I may be wrong in this, but I seem to remember that the original Newcast;e Diet pilot study came about because the Uni was wanting to see if it was possible to mimic the success of Bariatric Surgery as a cure for T2D, so to use diets as a means of reducing weight pre-op for that procedure is taking it full circle. Well, almost, it would if they coud use the ND as an alternative to bariatric surgery, thus saving the NHS fatloads of money. However, that surgery applies to many other conditions other than T2D, so that may not be so possible in the general run of things.

This thread is considering Low carb, not vLow Cal, but it remains to be seen which diet would be most effective as a treatment or replaccement procedure. According to the original Optifast info, both diets can be considered as ketogenic at least in part so they are not that dissimilar.

Edit to add: The Newcastle DIRECT follow on study uses the Cambridge Diet instead of Optifast meal replacement, but that diet too is considered to be mildly ketogenic.
 
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Guzzler

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From what I have heard the processes getting from initial referral for bariatric surgery to actually having the procedure takes quite a long time and it seems to me that all of this time could be spent on a lowered carb intake instead of just the pre op month. Wouldn't this serve more purposes? Weight loss overall, less fat in and around the liver and the possibility of patients deciding that dietary changes are showing such results as to delay/cancel surgery.
 
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Oldvatr

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Guzzler said:
From what I have heard the processes getting from initial referral for bariatric surgery to actually having the procedure takes quite a long time and it seems to me that all of this time could be spent on a lowered carb intake instead of just the pre op month. Wouldn't this serve more purposes? Weight loss overall, less fat in and around the liver and the possibility of patients deciding that dietary changes are showing such results as to delay/cancel surgery.
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Whilst I agree wholeheartedly with you on this, unfortunately the NHS is not so open to changing horses midstream, so will probably continue along their blinkered path for some time to come. Remember the consultants for this procedure are generally earning their crust from doing surgery procedures, They have a process that they know works, so have no real incentive to try new techniques, It will be up to the bean counters to step in I fear.

Although we view this procedure in the spotlight of diabetes, we must take into account that there are probably other conditions that it will benefit too, and it has the permanence aspect that also appeals to the NHS. It is a one shot fix. And there will continue to be a need to provide an efficient weight loss program for pre-op, so work on LC and vlcal diets will continue, and this will be of future benfit for those with diabetes.

I think it is a case of When, not If, for this surgery to become redundant in time as more studies show these diets to be safe, repeatable for all, and cost effective.
 
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