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Am J Physiol Endocrinol Metab 284: E1080-E1088, 2003. First published February 25, 2003; doi:10.1152/ajpendo.00185.2002
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Vol. 284, Issue 6, E1080-E1088, June 2003

Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery

Sai Krupa Das1, Susan B. Roberts1, Joseph J. Kehayias1, Jack Wang3, L. K. George Hsu2, Scott A. Shikora2, Edward Saltzman1,2, and Megan A McCrory1

1 Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston 02111; 2 New England Medical Center Hospital, Boston 02111, Massachusetts; and 3 Body Composition Unit, St. Luke's-Roosevelt Hospital Center, New York, New York 10025

Body composition methods were examined in 20 women [body mass index (BMI) 48.7 ± 8.8 kg/m2] before and after weight loss [-44.8 ± 14.6 (SD) kg] after gastric bypass (GBP) surgery. The reference method, a three-compartment (3C) model using body density by air displacement plethysmography and total body water (TBW) by H218O dilution (3C-H218O), showed a decrease in percent body fat (%BF) from 51.4 to 34.6%. Fat-free mass hydration was significantly higher than the reference value (0.738) in extreme obesity (0.756; P < 0.001) but not after weight reduction (0.747; P = 0.16). %BF by H218O dilution and air displacement plethysmography differed significantly from %BF by 3C-H218O in extreme obesity (P < 0.05) and 3C models using 2H2O or bioelectrical impedance analysis (BIA) to determine TBW improved mean %BF estimates over most other methods at both time points. BIA results varied with the equation used, but BIA better predicted %BF than did BMI at both time points. All methods except BIA using the Segal equation were comparable to the reference method for determining changes over time. A simple 3C model utilizing air displacement plethysmography and BIA is useful for clinical evaluation in this population.

three-compartment models


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