Pre-operative weight loss is not a predictor of weight loss after bariatric surgery
EAES Academy. Marrana F. 07/05/22; 362973; P016
Dr. Francisco Marrana
Contributions
Contributions
Abstract
Background:
Mandatory pre-operative weight loss is often required as admissibility criteria for bariatric surgery. Some authors propose that pre-operative weight loss is associated with patient compliance to dietary and lifestyle interventions, which are paramount in the management of obesity. However, there is no hard evidence confirming that pre-operative weight loss is related to the magnitude of post-operative weight loss. On the other hand, refusing bariatric surgery to patients who are unable to lose weight pre-operatively might exclude patients who need the most the surgically induced weight loss.
Aims: In this preliminary study we try to analyze if pre-operative weight change is associated with post-operative weight loss after bariatric surgery.
Methods:
Retrospective analysis of 198 patients treated in a Portuguese Community Hospital between January 2018 and September 2021. Statistical analysis was performed with SPSS v. 28 and p-values <0.05 were considered significant. Patients were analyzed regarding anthropometric data, weight change between the first outpatient visit and the day of the surgery and post-operative weight change.
Results:
Most patients were female. The mean BMI was 43.1 kg/m2. The most frequent surgery was gastric bypass (56.6%) followed by gastric sleeve (37.4%). Upon the first dietitian consultation, patients were proposed dietary optimization. Pre-operative weight loss was recommended but not required for surgery. In this period, 50% of the patients increased their weight and only 22.2% had a significant (>2kg) weight reduction. The 1 month %EWL was 26% and the 12 months %EWL was 81.5% and were not statistically different according to pre-operative weight change. Patient with pre-operative weight loss had significantly lower BMI (40.5 vs 44.5; p=0.03) at the day of surgery, although their maximum BMI was not different. After adjustment for initial BMI and type of surgery, pre-operative weight change was not related with 1 month and 12 months weight loss (p=0.9).
Conclusion:
Mandatory pre-operative weight loss is not associated with post-operative weight loss and might exclude patients who are the most in need of surgical treatment.
Mandatory pre-operative weight loss is often required as admissibility criteria for bariatric surgery. Some authors propose that pre-operative weight loss is associated with patient compliance to dietary and lifestyle interventions, which are paramount in the management of obesity. However, there is no hard evidence confirming that pre-operative weight loss is related to the magnitude of post-operative weight loss. On the other hand, refusing bariatric surgery to patients who are unable to lose weight pre-operatively might exclude patients who need the most the surgically induced weight loss.
Aims: In this preliminary study we try to analyze if pre-operative weight change is associated with post-operative weight loss after bariatric surgery.
Methods:
Retrospective analysis of 198 patients treated in a Portuguese Community Hospital between January 2018 and September 2021. Statistical analysis was performed with SPSS v. 28 and p-values <0.05 were considered significant. Patients were analyzed regarding anthropometric data, weight change between the first outpatient visit and the day of the surgery and post-operative weight change.
Results:
Most patients were female. The mean BMI was 43.1 kg/m2. The most frequent surgery was gastric bypass (56.6%) followed by gastric sleeve (37.4%). Upon the first dietitian consultation, patients were proposed dietary optimization. Pre-operative weight loss was recommended but not required for surgery. In this period, 50% of the patients increased their weight and only 22.2% had a significant (>2kg) weight reduction. The 1 month %EWL was 26% and the 12 months %EWL was 81.5% and were not statistically different according to pre-operative weight change. Patient with pre-operative weight loss had significantly lower BMI (40.5 vs 44.5; p=0.03) at the day of surgery, although their maximum BMI was not different. After adjustment for initial BMI and type of surgery, pre-operative weight change was not related with 1 month and 12 months weight loss (p=0.9).
Conclusion:
Mandatory pre-operative weight loss is not associated with post-operative weight loss and might exclude patients who are the most in need of surgical treatment.
Background:
Mandatory pre-operative weight loss is often required as admissibility criteria for bariatric surgery. Some authors propose that pre-operative weight loss is associated with patient compliance to dietary and lifestyle interventions, which are paramount in the management of obesity. However, there is no hard evidence confirming that pre-operative weight loss is related to the magnitude of post-operative weight loss. On the other hand, refusing bariatric surgery to patients who are unable to lose weight pre-operatively might exclude patients who need the most the surgically induced weight loss.
Aims: In this preliminary study we try to analyze if pre-operative weight change is associated with post-operative weight loss after bariatric surgery.
Methods:
Retrospective analysis of 198 patients treated in a Portuguese Community Hospital between January 2018 and September 2021. Statistical analysis was performed with SPSS v. 28 and p-values <0.05 were considered significant. Patients were analyzed regarding anthropometric data, weight change between the first outpatient visit and the day of the surgery and post-operative weight change.
Results:
Most patients were female. The mean BMI was 43.1 kg/m2. The most frequent surgery was gastric bypass (56.6%) followed by gastric sleeve (37.4%). Upon the first dietitian consultation, patients were proposed dietary optimization. Pre-operative weight loss was recommended but not required for surgery. In this period, 50% of the patients increased their weight and only 22.2% had a significant (>2kg) weight reduction. The 1 month %EWL was 26% and the 12 months %EWL was 81.5% and were not statistically different according to pre-operative weight change. Patient with pre-operative weight loss had significantly lower BMI (40.5 vs 44.5; p=0.03) at the day of surgery, although their maximum BMI was not different. After adjustment for initial BMI and type of surgery, pre-operative weight change was not related with 1 month and 12 months weight loss (p=0.9).
Conclusion:
Mandatory pre-operative weight loss is not associated with post-operative weight loss and might exclude patients who are the most in need of surgical treatment.
Mandatory pre-operative weight loss is often required as admissibility criteria for bariatric surgery. Some authors propose that pre-operative weight loss is associated with patient compliance to dietary and lifestyle interventions, which are paramount in the management of obesity. However, there is no hard evidence confirming that pre-operative weight loss is related to the magnitude of post-operative weight loss. On the other hand, refusing bariatric surgery to patients who are unable to lose weight pre-operatively might exclude patients who need the most the surgically induced weight loss.
Aims: In this preliminary study we try to analyze if pre-operative weight change is associated with post-operative weight loss after bariatric surgery.
Methods:
Retrospective analysis of 198 patients treated in a Portuguese Community Hospital between January 2018 and September 2021. Statistical analysis was performed with SPSS v. 28 and p-values <0.05 were considered significant. Patients were analyzed regarding anthropometric data, weight change between the first outpatient visit and the day of the surgery and post-operative weight change.
Results:
Most patients were female. The mean BMI was 43.1 kg/m2. The most frequent surgery was gastric bypass (56.6%) followed by gastric sleeve (37.4%). Upon the first dietitian consultation, patients were proposed dietary optimization. Pre-operative weight loss was recommended but not required for surgery. In this period, 50% of the patients increased their weight and only 22.2% had a significant (>2kg) weight reduction. The 1 month %EWL was 26% and the 12 months %EWL was 81.5% and were not statistically different according to pre-operative weight change. Patient with pre-operative weight loss had significantly lower BMI (40.5 vs 44.5; p=0.03) at the day of surgery, although their maximum BMI was not different. After adjustment for initial BMI and type of surgery, pre-operative weight change was not related with 1 month and 12 months weight loss (p=0.9).
Conclusion:
Mandatory pre-operative weight loss is not associated with post-operative weight loss and might exclude patients who are the most in need of surgical treatment.
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