Jejunoileal bypass for morbid obesity: early results and body composition changes in forty-five patients

Forty-five patients who underwent a 14 by 4 inch jejunoileal bypass for morbid obesity were studied before the operation and at periodic intervals after operation to determine the complications and changes in body composition resulting from this procedure. Body composition studies were determined using 3H2O and 42K. Rapid weight loss occurred in the first 3 months, with a mean loss of 30 percent of excess weight. This weight loss was accompanied by a decrease in exchangeable potassium (Ke) and total body water (TBW) during this interval by 14 and 10 percent, respectively. Although most patients continued to lose excess weight Ke and TBW stabilized at the end of the first year and returned to preoperative values in six patients at the end of 24 months. Analysis of the ratios of body cell mass and total body water to weight shows an improvement of body composition 12 months after operation. Body composition studies permit a quantitative assessment of the nutritional status in patients undergoing jejunoileal bypass. In spite of significant complications (23 percent), surgery for morbid obesity appears to satisfy the objective of allowing desirable loss of fat with relative sparing of muscle and other supporting tissues.