Effectiveness of a Modified Cost-Effective Dietary Plan in Promoting Weight Loss and Preservation of Lean Body Mass in Patients After Bariatric Surgery

NCT ID: NCT07111767

Last Updated: 2025-08-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

122 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-31

Study Completion Date

2026-06-30

Brief Summary

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This study will see if a low-cost dietary plan, based on the standard dietary guidelines of the American Society for Metabolic and Bariatric Surgery (ASMBS) and using locally available foods, can help patients lose weight and keep their lean body mass after bariatric surgery. It will also check if this plan can maintain healthy levels of important nutrients such as vitamin B12, iron, and vitamin D.

Patients who have undergone bariatric surgery will be randomly assigned to follow either the low-cost diet or the regular hospital diet. Their weight, body composition, and nutrient levels will be tracked at baseline, and at 1, 3, and 6 months after surgery.

The aim is to find out if this simpler, affordable diet, which follows international standards, works as well as the regular plan while being easier for low-income patients to follow.

Detailed Description

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Obesity is a growing global health problem and is recognized by the World Health Organization (WHO) as a leading cause of preventable disease. It is a complex, long-term condition influenced by multiple factors, and treatment options range from lifestyle changes to medications and surgery. Bariatric surgery is currently the most effective long-term treatment for morbid obesity. It not only helps in significant weight loss but also improves obesity-related health problems such as type II diabetes, hypertension, and obstructive sleep apnea, while improving quality of life.

Among the various surgical techniques, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one-anastomosis gastric bypass (OAGB/MGB) are the most commonly performed. However, these surgeries can lead to reduced absorption of essential nutrients because they bypass parts of the intestine where vitamins and minerals are absorbed. Nutrient deficiencies, particularly in vitamin B12, iron, and vitamin D, are common after bariatric surgery. Therefore, structured dietary management and supplementation are essential after surgery to prevent these deficiencies and preserve lean body mass (LBM).

Standard dietary recommendations from the American Society for Metabolic and Bariatric Surgery (ASMBS) suggest a gradual progression from liquids to solid foods, adequate protein intake (1.0-1.5 g/kg), and lifelong use of vitamin and mineral supplements. However, in countries like Pakistan, where 45% of the population lives below the international poverty line, the standard postoperative diet often includes costly imported supplements like whey protein, which are unaffordable and hard to access for most patients, particularly those from rural areas. This creates barriers to dietary compliance and worsens clinical outcomes.

Adequate protein intake plays a key role in preserving lean body mass and improving recovery after bariatric surgery. Nutritional deficiencies, particularly in vitamin B12, iron, and vitamin D, remain prevalent after bariatric surgery and require targeted nutritional strategies.

In response to these challenges, this study introduces a low-cost dietary plan based on ASMBS guidelines using locally available, affordable foods to meet protein and micronutrient needs. It aims to compare this plan with the conventional high-cost hospital diet to determine whether it can effectively promote weight loss, maintain lean body mass, and prevent micronutrient deficiencies. By aligning with international standards while addressing local socioeconomic constraints, this approach could improve patient adherence, nutritional outcomes, and overall recovery following bariatric surgery.

Conditions

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Obesity Bariatric Surgery Nutritional Status Body Composition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental Arm: Cost-effective Post-Operative diet

Participants in this arm will follow a low-cost dietary plan designed according to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines, using locally available, affordable foods to meet protein and micronutrient needs. The plan aims to promote weight loss, preserve lean body mass, and prevent nutrient deficiencies.

Group Type EXPERIMENTAL

Low-Cost Post-Bariatric Diet

Intervention Type DIETARY_SUPPLEMENT

Low-Cost Post-Bariatric Diet (Experimental):

Based on the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines.

Uses affordable, locally available foods (e.g., eggs, lentils, local dairy products) to meet protein and micronutrient needs.

Designed to be cost-effective and accessible for patients from low-income or rural areas.

Control - Standard High-Cost Postoperative Diet

Participants in this arm will follow the standard postoperative hospital diet, which includes expensive protein supplements (e.g., whey protein, cottage cheese) and imported nutritional products typically recommended after bariatric surgery.

Group Type ACTIVE_COMPARATOR

Standard High-cost Post-Bariatric Diet

Intervention Type DIETARY_SUPPLEMENT

Standard Post-Bariatric Diet (Active Comparator):

The conventional high-cost diet currently followed at the study hospital. Includes imported or expensive protein supplements such as whey protein and cottage cheese, along with nutritional products not easily accessible in rural or low-resource settings.

Interventions

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Low-Cost Post-Bariatric Diet

Low-Cost Post-Bariatric Diet (Experimental):

Based on the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines.

Uses affordable, locally available foods (e.g., eggs, lentils, local dairy products) to meet protein and micronutrient needs.

Designed to be cost-effective and accessible for patients from low-income or rural areas.

Intervention Type DIETARY_SUPPLEMENT

Standard High-cost Post-Bariatric Diet

Standard Post-Bariatric Diet (Active Comparator):

The conventional high-cost diet currently followed at the study hospital. Includes imported or expensive protein supplements such as whey protein and cottage cheese, along with nutritional products not easily accessible in rural or low-resource settings.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Able to give informed written consent
* Adults between the ages of 18 and 65 undergoing primary bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy, or OAGB)

Exclusion Criteria

* Patients having revision bariatric surgery
* Patients with recognized diseases related to micronutrient supplementation
* Patients with pre-existing gastrointestinal, metabolic, or endocrine disorders that impair nutrient absorption
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Khyber Teaching Hospital

OTHER

Sponsor Role lead

Responsible Party

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Dr Safina Tanveer

PRINCIPAL INVESTIGATOR| Trainee Medical Officer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Safina Tanveer, MBBS, FCPS-II

Role: PRINCIPAL_INVESTIGATOR

Khyber Teaching Hospital

Locations

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Khyber Teaching Hospital

Peshawar, Khyber Pakhtun Khwa, Pakistan

Site Status

Countries

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Pakistan

Central Contacts

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Safina Tanveer, MBBS,FCPS-II training

Role: CONTACT

0092 337 6919129

Facility Contacts

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Safina Tanveer, MBBS, FCPS-II in process

Role: primary

0092 337 6919129

References

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Via MA, Mechanick JI. Nutritional and Micronutrient Care of Bariatric Surgery Patients: Current Evidence Update. Curr Obes Rep. 2017 Sep;6(3):286-296. doi: 10.1007/s13679-017-0271-x.

Reference Type BACKGROUND
PMID: 28718091 (View on PubMed)

Related Links

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https://pubmed.ncbi.nlm.nih.gov/28718091/

Evidence-based guidelines from ASMBS on nutritional and micronutrient management for bariatric surgery patients, including dietary progression, protein intake, and supplementation strategies.

Other Identifiers

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661/DME/KMC

Identifier Type: -

Identifier Source: org_study_id

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