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Shedding Pounds Before Weight-Loss Surgery a Smart Move

WEDNESDAY, Feb. 14, 2018 (HealthDay News) -- By the time you've decided to have weight-loss surgery, you've probably given up on dieting altogether.

But a new study suggests that if you can drop some weight in the month before your procedure, you might have a smoother surgery and recovery -- and you could ultimately lose more weight.

Researchers asked people scheduled for weight-loss procedures to go on a low-calorie diet for a month before surgery. The diet consisted of about 1,200 calories daily from two meal replacement shakes and one healthy meal.

People who lost 8 percent or more of their excess body weight reduced the duration of their surgery, as well as the length of their hospital stay. And a year later, they lost almost 10 pounds more than those who hadn't succeeded at pre-surgery weight loss.

"These findings suggest that surgeons and clinical care teams should encourage healthy eating and exercise," said study author Deborah Hutcheon, a clinical nutrition specialist at Greenville Health Systems in South Carolina.

But Hutcheon was quick to emphasize that this eating plan was recommended, not mandated. And the study authors don't think this diet should be used as a requirement to gain insurance coverage.

Dr. Mitchell Roslin, director of the bariatric surgery program at Northern Westchester Hospital in Mount Kisco, N.Y., expressed the same concern.

"Sometimes results from studies like this are used in a negative way, such as for rationing care. Insurers might argue that good weight losers before the surgery don't need the surgery," said Roslin, who wasn't involved with the study.

Hutcheon agreed that a pre-surgery diet shouldn't be the basis for coverage or approval for surgery. She pointed out that some participants didn't meet the 8 percent weight-loss goal set by the study before their surgery, and they still did quite well.

The study included 355 people scheduled to undergo one of two weight-loss procedures. One hundred sixty-seven people were going to have vertical sleeve gastrectomy (a procedure that removes most of the stomach) and 188 were going to have gastric bypass.

All agreed to go on the low-calorie diet for four weeks preceding the surgery. While 224 people lost 8 percent or more of their excess weight, 131 did not.

Those who were successful at weight loss before surgery had surgeries that averaged eight minutes less time, and were able to get out of the hospital about one-quarter of a day earlier.

At three months after surgery, those who lost a significant portion of weight prior to surgery averaged a 42-pound weight loss, compared to 36 pounds for those not in the 8 percent group. At a year, the 8 percent or more group lost 65 pounds, while the other group lost less than 56 pounds.

How does losing weight ahead of time aid in weight-loss success?

Hutcheon said the program helped "patients establish healthy eating habits, establish portion control and learn what a healthy meal looks like."

She added that weight loss from the liver and abdominal cavity helps to improve surgical access, which may be why surgical times and recovery periods went down.

The study was published online recently in the Journal of the American College of Surgeons.

More information

Learn more about weight-loss surgeries from the American Society for Metabolic and Bariatric Surgery.

February 14, 2018
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