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Does weight loss immediately before bariatric surgery improve outcomes: a systematic review
Masha Livhits1, Cheryl Mercado, Irina Yermilov
1Department of Surgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California 90095, USA. mlivhits@mednet.ucla.edu
Summary
Preoperative weight loss before bariatric surgery is linked to better long-term results and improved patient compliance. This weight loss may also reduce operative time, indicating better surgical outcomes.
Area of Science:
- Bariatric Surgery Outcomes
- Metabolic and Endocrine Surgery
- Obesity Treatment Research
Background:
- Preoperative weight loss is theorized to improve bariatric surgery outcomes.
- Patient compliance and excess weight loss (EWL) are key metrics influenced by preoperative status.
- This study investigates the direct impact of pre-surgery weight reduction on post-surgery results.
Purpose of the Study:
- To determine the effect of preoperative weight loss on postoperative outcomes in bariatric surgery patients.
- To analyze patient factors associated with weight loss following bariatric procedures.
- To compare long-term weight loss and perioperative results between patients with and without preoperative weight loss.
Main Methods:
- A comprehensive MEDLINE search identified relevant studies on preoperative weight loss and bariatric surgery.
- Fifteen studies (n=3404) met the inclusion criteria, focusing on preoperative weight loss and postoperative weight reduction.
- A meta-analysis compared postoperative weight loss and perioperative outcomes for patients who did and did not lose weight preoperatively.
Main Results:
- Meta-analysis showed a significant increase in 1-year postoperative excess weight loss (EWL) of 5% for patients with preoperative weight loss.
- Patients who lost weight before surgery experienced a significant reduction in operative time (mean difference 23.3 minutes).
- While some studies showed positive short-term effects, others found no difference or even negative effects, highlighting variability.
Conclusions:
- Preoperative weight loss appears to be associated with greater postoperative weight loss after bariatric surgery.
- Preoperative weight loss may serve as an indicator for patients likely to exhibit better compliance post-surgery.
- Further research could explore the mechanisms linking preoperative weight loss to enhanced surgical outcomes and compliance.
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