title: Surgeon's requirement for obesity reduction: its influence on weight loss.
abstract: The objective of this study was to examine whether preoperative recommendation for specific reductions in body mass index (BMI) influenced weight loss in obese surgical patients. We retrospectively reviewed the electronic medical records of 48 patients who enrolled between January 2007  to June 2010 in an 800-calorie per day liquid meal replacement (LMR) weight loss program. Of these, 9 patients (surgical group) enrolled as a result of general surgeon-directed weight loss to enable nonbariatric surgery and 39 enrolled seeking weight loss (medical group). Patients enrolled  in the LMR program before bariatric surgery were excluded from analysis. All patients were seen in the setting of a comprehensive weight loss program supervised by a medical bariatrician and followed for a period of 4 months. There were no significant differences in mean initial BMI between  surgical and medical patients (41.7 ± 4.55 and 41.6 ± 8.54 kg/m(2), respectively) or participation time in the weight loss program (120 days vs 133 days). Of the nine surgical patients, only five (56%) reached their weight goal and underwent the planned surgical  procedure. Weight loss was significantly less in the surgical compared with medical patients (BMI reduction 4.03 ± 3.99 vs 7.75 ± 4.90 kg/m(2), respectively; P < 0.05). Weight loss was significantly lower in patients directed to undergo BMI reduction  to enable a general surgical procedure. Future studies are needed to assess factors influencing weight loss (metabolism, exercise capacity, motivation) in patients requiring weight loss to enable a surgical procedure.
authors.affiliation: Department of Surgery, Mayo Clinic-Florida, Jacksonville, Florida 32224, USA. goldberg.ross@mayo.edu
authors.forename: Ross F
authors.initials: RF
authors.lastname: Goldberg
authors.forename: Michael
authors.initials: M
authors.lastname: Parker
authors.forename: John A
authors.initials: JA
authors.lastname: Stauffer
authors.forename: Salman
authors.initials: S
authors.lastname: Moti
authors.forename: Jacob
authors.initials: J
authors.lastname: Sylvia
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Ames
authors.forename: Horacio J
authors.initials: HJ
authors.lastname: Asbun
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lynch
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
authors.forename: Steven P
authors.initials: SP
authors.lastname: Bowers
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000178:diet therapy; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D015431:Weight Loss; D061217:Weight Reduction Programs