University of Oulu

Vinciguerra, F., Longhitano, S., Carrubba, N. et al. Efficacy, feasibility and tolerability of ketogenic diet for the treatment of poor response to bariatric surgery. J Endocrinol Invest 46, 1807–1814 (2023).

Efficacy, feasibility and tolerability of ketogenic diet for the treatment of poor response to bariatric surgery

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Author: Vinciguerra, F.1; Longhitano, S.1; Carrubba, N.1;
Organizations: 1Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
2General and Emergency Surgery Department, Garibaldi Hospital, Catania, Italy
3Endocrinology Unit: Garibaldi Hospital, Catania, Italy
4Rovaniemi Health Center, Rovaniemi and Primary Health Care Unit, Lapland Central Hospital, Rovaniemi, Finland
5Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
6Diabetes, Obesity and Dietetic Center, Garibaldi Hospital, Catania, Italy
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Springer Nature, 2023
Publish Date: 2023-10-30


Purpose: Poor response to bariatric surgery, namely insufficient weight loss (IWL) or weight regain (WR), is a critical issue in the treatment of obesity. The purpose of our study was to assess the efficacy, feasibility, and tolerability of very low-calorie ketogenic diet (VLCKD) for the management of this condition.

Methods: A real-life prospective study was conducted on twenty-two patients who experienced poor response after bariatric surgery and followed a structured VLCKD. Anthropometric parameters, body composition, muscular strength, biochemical analyses, and nutritional behavior questionnaires were evaluated.

Results: A significant weight loss (mean 14.1 ± 4.8%), mostly due to fat mass, was observed during VLCKD with the preservation of muscular strength. The weight loss obtained allowed patients with IWL to reach a body weight significantly lower than that obtained at the post-bariatric surgery nadir and to report the body weight of patients with WR at the nadir observed after surgery. The significantly beneficial changes in nutritional behaviors and metabolic profiles were observed without variations in kidney and liver function, vitamins, and iron status. The nutritional regimen was well tolerated, and no significant side effects were detected.

Conclusion: Our data demonstrate the efficacy, feasibility, and tolerability of VLCKD in patients with poor response after bariatric surgery.

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Series: Journal of endocrinological investigation
ISSN: 0391-4097
ISSN-E: 1720-8386
ISSN-L: 0391-4097
Volume: 46
Issue: 9
Pages: 1807 - 1814
DOI: 10.1007/s40618-023-02034-2
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding provided by Università degli Studi di Catania within the CRUI-CARE Agreement.
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