[Multimodal obesity therapy-preconditioning neoadjuvant strategies prior to bariatric surgery]

Bariatric surgery is a key component of a multimodal treatment approach. In addition to surgery, conservative therapeutic options should be offered to promote preoperative weight loss and improve obesity-related comorbidities.

This review aims to present available preconditioning strategies and evaluate whether and to what extent they improve pre- and postoperative weight loss and reduce perioperative risks.

Analysis and discussion of current literature on the topic.

The data available are highly heterogeneous. Preoperative weight loss can be achieved through hypocaloric diets, intragastric balloon placement, or the addition of glucagon-like peptide‑1 (GLP-1) agonists to lifestyle interventions before bariatric procedures. However, studies have not yet confirmed a positive effect on perioperative risk or postoperative weight development.

Although some preconditioning strategies appear promising and are partly part of clinical routine, the current evidence base is insufficient to support uniform recommendations for preconditioning prior to bariatric surgery.