This exploratory cohort included 37 participants, recruited at Oxford University Hospitals to the Gastrointestinal Illnesses study (Ref: 16/YH/0247). All patients were characterised by metabolic status and medical history. Bariatric patients were considered eligible in accordance with National Institute for Health and Care Excellence (NICE) and local guidelines.

Patients with a history of alcoholism and/or ongoing anticoagulant treatment were excluded. Patients were also excluded in case of pregnancy, active substance abuse or uncontrolled psychiatric condition including eating disorders. Participants were sampled at baseline and subjected to 3-week low calorie carbohydrate-restricted diet (900 kcal/day, maximum 100 g of carbohydrates per day), followed by bariatric surgery. The sequential follow-up timepoints included the day of the surgery (baseline), at 20% of weight loss after 6.54 ± 3.4 months (mean ± IQR) and 12.47 ± 6.55 months post-op. Characteristics of the bariatric cohort are shown in Table Table11.

Demographic characteristics of the bariatric cohort.

aBMI reference values: <18.5 (underweight), 18.5–24.9 (normal weight), 25–29.9 (overweight), >30 (obese).

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