The Benefits of Weight Loss Before Bariatric Surgery

Current research has tipped the scales in a new direction to promote weight loss before bariatric surgery. The success with preoperative weight loss has provided long-term and short-term outcomes regarding decreased mortality rate 30 days after surgery, reduction in liver volume, decreased length of hospital stay, increased weight loss postoperative, shorter operating time, and decreased adipose tissue in the body [1,2,3].

It has been determined that preoperative weight loss, even at a moderate degree (>0% to <5%), can be associated with significantly lower risk of 30-day mortality following bariatric surgery [1]. Preoperative weight loss under the guidance of a bariatric healthcare team, has improved postoperative outcomes, reduced mortality, and has shown better control of hyperglycemia during the hospital stay [1]. Findings have shown that even a small reduction in weight before surgery was associated with a 24% decrease in the odds of 30-day mortality following bariatric surgery [1].  

Further research has been done over the course of a 12 week period, involving individuals on a very low energy diet (456-680 kcal/day) under the observation of a registered dietitian and health care team [2]. This diet required the consumption of meal replacement shakes, low-starch vegetables, vitamin and mineral supplements, about 2 liters of calorie-free beverages per day, and physical activity. The outcome of this study provided insight on short-term and long-term benefits of weight loss before bariatric surgery. Preoperative weight loss tracked over a 12 week period resulted in a reduction of adipose tissue, as well as, a head start on lifestyle change that provided better adherence after bariatric surgery. The short-term (over a 2 week period) benefits to weight loss included the reduction in liver size resulting in decreased risk of complications and better access to the stomach during weight loss surgery [2]. High protein intake has been utilized preoperatively in addition to a very low calorie diet to maintain lean muscle so the body does not break it down as energy and burns fat instead. A high protein diet may also help bariatric patients become better acquainted with the idea of high protein daily after surgery (60-80 g/day). 

Reducing the size of the liver can make a big difference in surgical complexity. It has been shown that Nonalcoholic Fatty Liver Disease (NAFLD) is seen in one-third of individuals who are severely obese (BMI >35) [2]. This disease is characterized by excess fat accumulation in the liver cells. The enlargement can increase surgical risk and complexity in patients undergoing bariatric surgery. The most appropriate treatment option for NAFLD has yet to be decided, but weight reduction is the primary focus in the management of NAFLD associated with obesity [2]. 

With current research in mind, Bariatric Fusion continues to offer a liver reduction program 2 weeks before surgery. This program includes a high protein, low calorie diet by consuming Bariatric Fusion high protein meal replacement shakes to promote weight loss and reduce liver size. This program can be tailored to the patient and adjusted based on bariatric health care team recommendations. The preoperative use of Bariatric Fusion high protein, low calorie meal replacements can also help to transition a patient into using the product postoperatively to ensure adequate protein intake, maintaining lean body mass, and promoting healing. 


References

[1] Sun, Y., Liu, B., Smith, J. K., Correia, M. L., Jones, D. L., Zhu, Z., . . . Bao, W. (2020). Association of Preoperative Body Weight and Weight Loss With Risk of Death After Bariatric Surgery. JAMA Network Open, 3(5). doi:10.1001/jamanetworkopen.2020.4803

[2] Colles, S. L., Dixon, J. B., Marks, P., Strauss, B. J., & O’Brien, P. E. (2006). Preoperative weight loss with a very-low-energy diet: Quantitation of changes in liver and abdominal fat by serial imaging. The American Journal of Clinical Nutrition, 84(2), 304-311. doi:10.1093/ajcn/84.2.304

[3] Hutcheon, D. A., Hale, A. L., Ewing, J. A., Miller, M., Couto, F., Bour, E. S., . . . Scott, J. D. (2018). Short-Term Preoperative Weight Loss and Postoperative Outcomes in Bariatric Surgery. Journal of the American College of Surgeons, 226(4), 514-524. doi:10.1016/j.jamcollsurg.2017.12.032