Pre-operative dietary restriction for patients undergoing bariatric surgery in the UK: observational study of current practice and dietary effects.
BACKGROUND
Bariatric surgery is effective at achieving weight loss in the severely obese, with the majority of procedures performed laparoscopically. A short-term pre-operative energy restrictive diet is widely adopted to enable surgery by reducing liver size and improving liver flexibility. However, the dietary approach is not standardised. This observational study reports on pre-operative restrictive diets in use across bariatric services in the UK.


METHODS
Between September and November 2012, information was collected from bariatric services on current or past pre-operative diets, and any research providing evidence for the use or modification of their diets.


RESULTS
Around one third of bariatric services (28) in the UK responded, with a total of 49 diets in current use. Types of diet include low energy, low carbohydrate and liquid, with 59 % offering low energy/low carbohydrate food-based, 21 % milk/yoghurt, 18 % meal replacement (liquid) and 2 % clear liquid. Diet duration varies between 7 and 42 days. Limited anecdotal evidence was provided by services evaluating the pre-operative diet, and its alternative approaches, with dietary choice primarily clinician-led.


CONCLUSIONS
This study has highlighted variability and lack of consensus in the form of pre-bariatric surgery diet used across different centres. Further research comparing outcomes for alternative diets would support best practice in the future.
University of Nottingham School of Life Sciences, Queens Medical Centre, Nottingham, NG7 2UH, UK, mbxeb@nottingham.ac.uk.
Emma L
EL
Baldry
Paul C
PC
Leeder
Iskandar R
IR
Idris
D050110:Bariatric Surgery; D031204:Caloric Restriction; D003430:Cross-Sectional Studies; D050528:Diet, Carbohydrate-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D009929:Organ Size; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods*; D006113:United Kingdom; D015431:Weight Loss
D004040:Dietary Carbohydrates