(P31-065-23) Bariatric Surgery: What Is Already Achieved, What Could Be Improved?

Objectives: Bariatric surgery is often the only way to reduce substantial weight in severely obese patients and this surgical procedure has nearly doubled in the last years. The objective of this overview is to shortly describe the medical procedure and to summarize the data obtained regarding weight loss and the success rate of retaining it. A change from liquid food intake to chewing gummies containing whey and colostrum (first milk) is discussed and suggested.

Methods: Results from different studies are presented and interrelated, experiments using cell cultures, in-vivo animal models and some clinical trials. A general picture is developed that describes weight loss and its retainment following the surgical procedure, the reduced size of the stomach and change of taste and food preference.

Results: Oral nutrition after bariatric surgery has a limit as the stomach may be the size of a Kiwi fruit. Liquid protein shakes with whey protein were given as food in several studies to prevent muscle loss and increase the resting metabolic rate. Milk whey protein is rich in leucine which stimulates muscle protein synthesis, is easy to digest, and available in purified form. It also contains the protein lactoferrin which protects the intestine against iron-dependent pathogenic bacteria. Colostrum has not been given as food after bariatric surgery but it is an ideal food to protect the vulnerable intestine of newborns, and this concept could be used to improve intestinal healing and help to generate a healthy microbiome after surgery. Bovine colostrum could be used in patients who tolerate dairy and purified chewable tablets are already available. Clinical studies showed that compliance is a serious problem, and patients often get tired of drinking nutrients and could get malnourished. The use of gummies which allows chewing satisfaction may be promising. We suggest improving the recovery of patients by developing specific gummies containing whey protein with different flavors.

Conclusions: Bariatric surgery leads to weight loss but also to dramatic changes in food intake in patients who need all possible dietary and mental support to comply with the whole treatment. Improvement of the limited nutrition in these patients may focus on protection, healing, and healthy microbiomes in addition to the wanted weight loss.

Funding Sources: No funding sources