HEALTH:
Best to slim down before weight-loss surgery

2010/02/07

HAVING weight-loss surgery? Shedding a few kilogrammes before the surgery might reduce your risk of having surgical complications, a new study hints. A look back at the medical records of 881 patients who had weight-loss surgery found that the more weight patients lost before surgery, the less likely they were to suffer post-op complications, such as infections, blood clots, and kidney problems.

Preoperative weight changes varied among the 881 patients, ranging from modest weight gain to weight loss of more than 10 per cent of excess body weight.

The post-surgery complication rate was nearly twofold higher in patients who gained weight before surgery relative to those who lost weight before surgery, Dr Peter N. Benotti of the Saint Francis Medical Centre in Trenton, New Jersey and colleagues report in the Archives of Surgery.

All of the patients had undergone open or "keyhole" Roux-en-Y gastric bypass surgery. With this procedure, staples are used to create a pouch in the stomach that can hold only a small amount of food at a time; then, a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine.

Patients who had the more-invasive open surgery were at increased risk of post-op complications, regardless of whether they gained or lost weight before the surgery, the researchers found.

The popularity of weight-loss surgery has increased in recent years and so too have the numbers of patients seeking surgery who are older and sicker, the researchers note.

As more of these high-risk patients seek out surgical weight-loss options, doctors are facing a need to identify risk factors and help prepare patients for successful surgery.

The current study, the researchers say, suggests that pre-surgery weight loss may be one step that will help those having weight-loss surgery to achieve a more favourable outcome.

Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery, Benotti and colleagues note.

However, others believe that mandated pre-surgery weight loss "may be a deterrent to surgery".

Benotti says patients need to know that weight-loss surgery "is not a definitive treatment".

He says a healthy diet, lifestyle change, and behaviour modification are essential for maintaining weight loss after surgery. -- Reuters