title: Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery.
abstract: OBJECTIVE
  Modest, preoperative weight loss will improve perioperative outcomes among high-risk, morbidly obese patients undergoing Roux-en-Y gastric bypass.
  
  
  METHODS
  A prospective, longitudinal assessment of characteristics and outcomes of gastric bypass patients.
  
  
  METHODS
  All patients undergoing open or laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity or its comorbid medical problems at Geisinger Medical Center in Danville, Pennsylvania, during a 3-year period from May 31, 2002, to February 24, 2006, were included in this analysis. Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional, and surgical interventions and education. In addition, patients were encouraged to achieve a 10% loss of excess body weight prior to surgical intervention.
  
  
  RESULTS
  Of the 884 subjects, 425 (48%) lost more than 10% of their excess body weight prior to the operation. After surgery (mean follow-up, 12 months), this group was more likely to achieve 70% loss of excess body weight (P < .001). Those who lost more than 5% of excess body weight prior to surgery were statistically less likely to have a length of stay of greater than 4 days (P = .03).
  
  
  CONCLUSIONS
  This study shows that high-risk morbidly obese candidates for bariatric surgery who are able to achieve a loss of 5% to 10% excess body weight prior to surgery have a higher probability of a shorter length of hospital stay and more rapid postoperative weight loss.
authors.affiliation: Geisinger Health Care System, Department of Gastroenterology and Nutrition, 100 N Academy Rd, Mail Code 2111, Danville, PA 17882-2111, USA. cstill@geisinger.edu
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Still
authors.forename: Peter
authors.initials: P
authors.lastname: Benotti
authors.forename: G Craig
authors.initials: GC
authors.lastname: Wood
authors.forename: Glenn S
authors.initials: GS
authors.lastname: Gerhard
authors.forename: Anthony
authors.initials: A
authors.lastname: Petrick
authors.forename: Mary
authors.initials: M
authors.lastname: Reed
authors.forename: William
authors.initials: W
authors.lastname: Strodel
mesh_terms: D000328:Adult; D000368:Aged; D031204:Caloric Restriction; D037001:Directive Counseling; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy*; D010353:Patient Education as Topic; D011300:Preoperative Care; D016896:Treatment Outcome; D015431:Weight Loss