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Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes? A pilot randomized

Manish Parikh1, Meena Dasari, Michelle McMacken

  • 1Bellevue Center for Obesity and Weight Management, Bellevue Hospital Center, Department of Surgery, New York University School of Medicine, New Bellevue 15 South 7, 550 First Avenue, New York, NY 10016, USA. manish.parikh@nyumc.org

Surgical Endoscopy
|October 21, 2011
PubMed
Summary
This summary is machine-generated.

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Medically supervised weight management (MSWM) programs do not significantly improve weight loss after laparoscopic adjustable gastric banding (LAGB). However, MSWM may positively impact physical activity in bariatric surgery candidates.

Area of Science:

  • Bariatric Surgery
  • Weight Management
  • Public Health

Background:

  • Insurance payors often mandate medically supervised weight management (MSWM) programs before bariatric surgery.
  • Evidence supporting this requirement for bariatric surgery candidates is limited.
  • This study investigates the necessity of MSWM programs.

Purpose of the Study:

  • To evaluate if participation in a MSWM program predicts outcomes after laparoscopic adjustable gastric banding (LAGB).
  • To assess the impact of MSWM on weight loss and patient behaviors in a publicly insured population undergoing LAGB.

Main Methods:

  • A pilot randomized controlled trial was conducted at a public urban hospital.
  • Patients were randomized to either a 6-month MSWM program or usual care.

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  • Weight, demographics, and patient behavior scores were collected preoperatively and postoperatively.

    • Main Results:

    • No significant differences in postoperative weight loss or most patient behaviors were observed between groups.
    • Participants in the MSWM program attended an average of 2 preoperative sessions.
    • A positive effect on postoperative physical activity was noted in the MSWM group.

    Conclusions:

    • MSWM programs do not appear to offer additional benefits over standard protocols for weight loss and most behavioral outcomes after LAGB.
    • The findings suggest that mandatory MSWM may not be necessary for all bariatric surgery candidates.