Most people that visit our surgery to learn more about bariatric surgery options have already at some point in their lives tried to lose weight on their own, whether this be through a diet, exercise program or meal replacements. Unfortunately after reaching an unhealthy weight and sustaining this weight gain over a prolonged period of time, traditional diets and exercise regimes simply aren’t effective enough to lose the amount of excess weight for a healthier life.
A recent study published by the Journal of the American College of Surgeons evaluated the benefit of losing weight before having bariatric surgery and 
the results were very interesting. Patients who lose at least 8% of their excess body weight four weeks before undergoing bariatric surgery achieve a greater weight loss over the next twelve months than those who do not lose this amount preoperatively. This new research is indicative that pre-surgery weight loss should be encouraged to obtain maximum success.
“Our ultimate goal was to see what makes postoperative outcomes better for our patients undergoing this lifesaving procedure,” senior author John David Scott, MD, Associate Professor of Surgery, University of South Carolina School of Medicine, Greenville, said in a statement from his institution.
“[So while] the recommendation of 8% excess weight loss during a preoperative low calorie diet should be viewed by surgeons and patients as a goal or aspiration, rather than a requirement, achieving this goal may enable patients to reap stronger postoperative outcomes, including greater weight loss,” he and his coauthors say.
The Data Supporting Preoperative Weight Loss
The study involved 167 patients who underwent a sleeve gastrectomy and 188 patients who underwent a gastric bypass. Patients were given the chance to lose at least 8% of their excess weight by following a calorie controlled diet four weeks before their surgery.
Not all of the patients managed to lose >8% excess body weight during the four weeks, which allowed for the two sets of data to be compared over time. Three, six and twelve months after weight loss surgery patients in the >8% preoperative excess weight loss group achieved a higher average body weight loss than those who weren’t able to lose weight pre-surgery.
Patients that preoperatively lost >8%:
After 3 months – 42.3% average percentage body weight loss
After 6 months – 56% average percentage body weight loss
After 12 months – 65.1% average percentage body weight loss
Patients who didn’t lose up to 8% excess body weight preoperatively:
After 3 months – 36.1% average percentage body weight loss
After 6 months – 47.5% average percentage body weight loss
After 12 months – 55.7% average percentage body weight loss
The results clearly show that being able to lose over 8% excess body weight preoperatively does correlate with a greater weight loss during the postoperative period. Not only were these patients able to lose more weight they also found that these patients did not need to stay in hospital as long postoperatively (1.8 days for those who achieved >8% weight loss, versus 2.1 for those who did not).
The Window of Opportunity
Although losing weight before your surgery isn’t something that is mandatory, this recent study certainly highlights the benefits of doing so. Hutcheon, a clinical nutrition specialist who conducted the study believes there is a “window of opportunity” following weight loss surgery that lasts up to 18 months, during which time physical and metabolic changes occur that help promote weight loss.
“After that time point, patients will have to rely on diet, exercise, and lifestyle management to maintain that weight loss,” she said. “We call it the honeymoon period of bariatric surgery,” Dr Scott elaborated.
“After a year, or a year and a half, your body starts to figure out what it can and can’t do, and your behaviors may change a little bit, so the odds that you are going to lose a significant amount of weight after that time are definitely decreased.”
So essentially the more weight you can lose during the “honeymoon period” the better, and if you are able to lose a minimum of 8% excess body fat prior to surgery, you are therefore increasing your chances of losing the maximum amount of weight possible.
If you are considering bariatric surgery and would like to know more about it you can find information on the different surgery types on our website, or contact our team online or call us to discuss further on 02 9553 1120.
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