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Effectiveness, Compliance, and Acceptability of Preoperative Weight Loss with a Liquid Very Low-Calorie Diet Before Bariatric Surgery in Real Practice

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Abstract

Objective

A preoperative very low-calorie diet (VLCD) is a common method to reduce weight before bariatric surgery. However, patient compliance and acceptability are not always known. The aim of this study is to evaluate the effectiveness, compliance, and acceptability of our regimen in a metropolitan academic quaternary care center.

Methods

Patients with a BMI < 50 kg/m2 and a BMI ≥ 50 kg/m2 were instructed to be on a liquid VLCD for 1 week and 2 weeks, respectively. The primary outcome was the amount of weight loss. Secondary outcomes were patient compliance and acceptability of either regimen using a questionnaire for hunger, satisfaction, desire, and deviation for solids.

Results

The study included 128 patients. Ninety-four patients were in the BMI < 50 kg/m2 group, and 34 patients were in the BMI ≥ 50 kg/m2 group. The BMI ≥ 50 kg/m2 group had a greater percentage of total weight loss (mean ± SD) than that of the BMI < 50 kg/m2 group without statistical differences (4.4 ± 1.3% vs. 3.8 ± 1.6%, p = 0.072). There were no statistical differences between the groups in terms of hunger, satisfaction with a liquid diet, or satisfaction of eating over drinking. However, hunger sensation (median [IQR]) tended to be higher in the BMI < 50 kg/m2 group than that in the BMI ≥ 50 kg/m2 group (2 [2] vs. 2 [2, 3]; p = 0.06). There was no statistical difference in the percentage of patient compliance between the groups (75.5% [n = 71] vs. 61.8% [n = 21], p = 0.18).

Conclusions

Preoperative liquid VLCD provided a modest amount of weight loss and showed a high rate of patient compliance and acceptability.

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References

  1. WHO Obesity and overweight Fact sheet, Updated 2017. Available from: http://www.who.int/mediacentre/factsheets/fs311/en.

  2. Ponce J, Nguyen NT, Hutter M, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011-2014. Surg Obes Relat Dis. 2015;11(6):1199–200.

    Article  PubMed  Google Scholar 

  3. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  4. Puzziferri N, Roshek 3rd TB, Mayo HG, et al. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312(9):934–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Courcoulas AP, Yanovski SZ, Bonds D, et al. Long-term outcomes of bariatric surgery: a National Institutes of Health symposium. JAMA surgery. 2014;149(12):1323–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Maciejewski ML, Arterburn DE, Van Scoyoc L, et al. Bariatric surgery and long-term durability of weight loss. JAMA surgery. 2016;151(11):1046–55.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sjöström L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA. 2014;311(22):2297–304.

    Article  CAS  PubMed  Google Scholar 

  8. Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7(6):760–7.

    Article  PubMed  Google Scholar 

  9. Gerber P, Anderin C, Thorell A. Weight loss prior to bariatric surgery: an updated review of the literature. Scand J Surg. 2015;104(1):33–9.

    Article  CAS  PubMed  Google Scholar 

  10. Van Nieuwenhove Y, Dambrauskas Z, Campillo-Soto A, et al. Preoperative very low-calorie diet and operative outcome after laparoscopic gastric bypass: a randomized multicenter study. Arch Surg. 2011;146(11):1300–5.

    Article  PubMed  Google Scholar 

  11. Faria SL, Faria OP, de Almeida CM, et al. Effects of a very low calorie diet in the preoperative stage of bariatric surgery: a randomized trial. Surg Obes Relat Dis. 2015;11(1):230–7.

    Article  PubMed  Google Scholar 

  12. Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5. discussion 5-6

    Article  PubMed  Google Scholar 

  13. Anderin C, Gustafsson UO, Heijbel N, et al. Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg). Ann Surg. 2015;261(5):909–13.

    Article  PubMed  Google Scholar 

  14. Gerber P, Anderin C, Gustafsson UO, et al. Weight loss before gastric bypass and postoperative weight change: data from the Scandinavian Obesity Registry (SOReg). Surg Obes Relat Dis. 2016;12(3):556–62.

    Article  PubMed  Google Scholar 

  15. Kim JJ, Rogers AM, Ballem N, et al. ASMBS updated position statement on insurance mandated preoperative weight loss requirements. Surg Obes Relat Dis. 2016;12(5):955–9.

    Article  PubMed  Google Scholar 

  16. Holderbaum M, Casagrande DS, Sussenbach S, et al. Effects of very low calorie diets on liver size and weight loss in the preoperative period of bariatric surgery: a systematic review. Surg Obes Relat Dis. 2018;14(2):237–44.

    Article  PubMed  Google Scholar 

  17. Schouten R, van der Kaaden I, van’t Hof G, et al. Comparison of preoperative diets before bariatric surgery: a randomized, single-blinded, non-inferiority trial. Obes Surg. 2016;26(8):1743–9.

    Article  PubMed  Google Scholar 

  18. Alger-Mayer S, Polimeni JM, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18(7):772–5.

    Article  PubMed  Google Scholar 

  19. Kadeli DK, Sczepaniak JP, Kumar K, et al. The effect of preoperative weight loss before gastric bypass: a systematic review. J Obes. 2012;2012:867540.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moreno B, Bellido D, Sajoux I, et al. Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity. Endocrine. 2014;47(3):793–805.

    Article  CAS  PubMed  Google Scholar 

  21. Adrianzen Vargas M, Cassinello Fernandez N, Ortega SJ. Preoperative weight loss in patients with indication of bariatric surgery: which is the best method? Nutr Hosp. 2011;26(6):1227–30.

    CAS  PubMed  Google Scholar 

  22. Schouten R, Rijs CS, Bouvy ND, et al. A multicenter, randomized efficacy study of the EndoBarrier gastrointestinal liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251(2):236–43.

    Article  PubMed  Google Scholar 

  23. Carbajo MA, Castro MJ, Kleinfinger S, et al. Effects of a balanced energy and high protein formula diet (Vegestart complet(R)) vs. low-calorie regular diet in morbid obese patients prior to bariatric surgery (laparoscopic single anastomosis gastric bypass): a prospective, double-blind randomized study. Nutr Hosp. 2010;25(6):939–48.

    CAS  PubMed  Google Scholar 

  24. Colles SL, Dixon JB, Marks P, et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84(2):304–11.

    Article  CAS  PubMed  Google Scholar 

  25. Fris RJ. Preoperative low energy diet diminishes liver size. Obes Surg. 2004;14(9):1165–70.

    Article  PubMed  Google Scholar 

  26. Kim JJ. Evidence base for optimal preoperative preparation for bariatric surgery: does mandatory weight loss make a difference? Curr Obes Rep. 2017;6(3):238–45.

    Article  PubMed  Google Scholar 

  27. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Houchins JA, Tan SY, Campbell WW, et al. Effects of fruit and vegetable, consumed in solid vs beverage forms, on acute and chronic appetitive responses in lean and obese adults. Int J Obes. 2013;37(8):1109–15.

    Article  CAS  Google Scholar 

  29. Flood-Obbagy JE, Rolls BJ. The effect of fruit in different forms on energy intake and satiety at a meal. Appetite. 2009;52(2):416–22.

    Article  PubMed  Google Scholar 

  30. Klempel MC, Bhutani S, Fitzgibbon M, et al. Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss. Nutr J. 2010;9:35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Gonzalez-Perez J, Sanchez-Leenheer S, Delgado AR, et al. Clinical impact of a 6-week preoperative very low calorie diet on body weight and liver size in morbidly obese patients. Obes Surg. 2013;23(10):1624–31.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the entire staff of Loyola Center for Metabolic Surgery & Bariatric Care at Melrose Park, IL, U.S.A. for helping with the data retrieval and providing the essential information. We would also like to thank Ms. Nannapat Pruphetkeaw from the Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand, for her assistance in performing the statistical analysis of the data and Mr. Glenn Shingledecker, in the Office of International Affairs, Faculty of Medicine, Prince of Songkla University for the proofreading and language support.

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Authors and Affiliations

  1. Department of Surgery, Division of GI/Minimally Invasive Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA

    Kamthorn Yolsuriyanwong, Komdej Thanavachirasin, Jessica Bartfield, Eric Marcotte & Bipan Chand

  2. Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand

    Kamthorn Yolsuriyanwong

  3. Loyola University Medical Center, Maywood, IL, USA

    Kimberly Sasso & Lauren Zuro

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  1. Kamthorn Yolsuriyanwong
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  2. Komdej Thanavachirasin
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Correspondence to Bipan Chand.

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The authors declare that they have no conflicts of interest.

Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study.

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Yolsuriyanwong, K., Thanavachirasin, K., Sasso, K. et al. Effectiveness, Compliance, and Acceptability of Preoperative Weight Loss with a Liquid Very Low-Calorie Diet Before Bariatric Surgery in Real Practice. OBES SURG 29, 54–60 (2019). https://doi.org/10.1007/s11695-018-3444-0

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  • DOI: https://doi.org/10.1007/s11695-018-3444-0

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