Weight loss prior to bariatric surgery: an updated review of the literature.
OBJECTIVE
Prior to bariatric surgery, a preoperative weight-reducing regimen is usually adhered to in most centers. The clinical effects of such a regimen are yet to be determined.


METHODS
We reviewed the current literature by searching in PubMed for publications reporting clinical effects resulting from a preoperative weight loss regimen prior to bariatric surgery published from January 1, 1995 to April 30, 2014.


RESULTS
In total, we identified 23 original publications and 2 review articles which met all inclusion criteria. These were included and fully analyzed with regard to effects of preoperative weight loss. In general, for parameters such as operating time and intraoperative complications including blood loss and recovery, inconsistent data were reported. Most studies included low number of patients and with heterogenic designs, and the results could not form the base for recommendations. However, for outcomes such as postoperative complications and weight development over time, data from large-scale studies and randomized controlled trials suggest beneficial effects following adherence to weight loss prior to bariatric surgery.


CONCLUSIONS
Although a large amount of data in the current literature on the effects of weight loss prior to bariatric surgery are inconsistent for many outcome parameters, recently published results regarding effects on postoperative complications and weight development over time strongly suggest that such a regimen should be recommended. Whether a certain degree of weight loss should be mandatory before being accepted for bariatric surgery is, however, still controversial.
Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden Department of Surgery, Ersta Hospital, Stockholm, Sweden.
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Gerber
Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden Department of Surgery, Ersta Hospital, Stockholm, Sweden.
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Anderin
Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden Department of Surgery, Ersta Hospital, Stockholm, Sweden anders.thorell@erstadiakoni.se.
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Thorell
D050110:Bariatric Surgery; D031204:Caloric Restriction; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery* / Q000628:therapy; D057234:Preoperative Period; D016896:Treatment Outcome; D015431:Weight Loss
Bariatric surgery; complications; low-calorie intake; preoperative; very low-calorie intake; weight loss