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Do Mandated Weight Loss Goals Prior to Bariatric Surgery Improve Postoperative Outcomes?

  • Sara Monfared
  • Dimitrios I. AthanasiadisEmail author
  • Alvin Furiya
  • Annabelle Butler
  • Don Selzer
  • William Hilgendorf
  • Ambar Banerjee
  • Dimitrios Stefanidis
Original Contributions

Abstract

Background

Most patients pursuing bariatric surgery undergo mandated preoperative weight management programs. The purpose of this study was to assess whether preoperative mandated weight loss goals lead to improved perioperative morbidity, postoperative weight loss, and resolution of comorbidities.

Methods

Data from patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic sleeve gastrectomy (LSG) between October 2012 and October of 2015 was reviewed. Patients were divided in two groups: those with BMI of 35–45 were not required to achieve a weight loss goal prior to surgery (no-WLG group) while those with BMI > 45 were given a weight loss goal proportionate to their weight (WLG group). Body mass index (BMI), history of diabetes mellitus type-II (DM-II), hypertension (HTN), hyperlipidemia (HLD), and obstructive sleep apnea (OSA) were recorded at baseline and 4 years postoperatively. Length of hospital stay (LOS) and reinterventions were considered proxies for postoperative morbidity.

Results

A total of 776 patients, 81.4% LRYGB, were included in the study (age 45.1 ± 11.9). There was no difference in %ΔBMI, DM-II, HDL, HTN, LOS, or reinterventions among the two groups at 4 years postoperatively in both LRNY and LSG patients. This lack of difference persisted even when patients with similar BMI (43–45 vs 45.01–47) were compared.

Conclusion

WLG group did not have decreased perioperative morbidity, nor improved weight loss and comorbidity resolution 4 years after surgery. While these findings should also be confirmed by multicenter trials, they question the value of mandated WLG prior to bariatric surgery as they seem ineffective and may limit patient access to surgery.

Keywords

Preoperative weight loss Medically supervised weight loss Goal setting Bariatric surgery Outcomes 

Notes

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Formal consent

For this type of study, formal consent is not required.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryIndiana University School of MedicineIndianapolisUSA
  2. 2.Rotary Building at Indiana UniversityIndianapolisUSA
  3. 3.Department of SurgeryIndiana University HealthIndianapolisUSA

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