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Energy balance
LSG increases the excretion of nonesterified fatty acids (NEFAs) and alters bile acid metabolism, leading to increased malabsorption of energy-rich substrates, whereas VLCD does not significantly alter faecal fatty acid excretion.
Surgery (LSG) physically changes how your body handles fat, causing you to excrete more of it rather than absorbing it. This malabsorption contributes to weight loss independently of how much you eat.
ModerateSupportsMEDIUM confidence
LSG resulted in enhanced faecal excretion of nonesterified fatty acids and bile acids. ... there was an increased loss of overall 40 different fatty acids 6 months after LSG compared to preoperative values resulting in a faecal excretion of summed fatty acid concentrations from preoperative 1,726 ± 1,093 μM to 3,554±1,872 μM at month 3 and 6,106±1,005 μM at month 6 (P = 0.005)
Why this rating
Small sample size, but clear statistical significance in fatty acid excretion.
Source
Effects of Surgical and Dietary Weight Loss Therapy for Obesity on Gut Microbiota Composition and Nutrient Absorption
Antje Damms-Machado et al. · BioMed Research International · 2015
DOI 10.1155/2015/806248
clinical_study · n=10Cited 292×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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- Laparoscopic sleeve gastrectomy (LSG) induces a leaner gut microbiota phenotype (increased Bacteroidetes, decreased Firmicutes) and enhances fat malabsorption, whereas very low calorie diet (VLCD) increases the energy-reabsorbing potential of the microbiota despite achieving identical weight loss.Moderate
- VLCD increases the microbial metabolic capacity for butyrate fermentation, whereas LSG decreases it, despite no significant change in actual faecal butyrate concentrations for either group.Moderate
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