I know what you’re thinking – why would I try to lose weight before bariatric surgery? Isn’t that the whole point? Well, losing weight through diet, exercise, and other lifestyle modifications is a common practice before undergoing bariatric surgery. Here are just a few reasons why you should consider preoperative weight loss:
Think of the weight loss prior to surgery like a bonus – it only adds to your overall net weight loss. If you lose more before bariatric surgery, you won’t lose less after. Using techniques for nonsurgical weight loss or participating in a medically supervised weight loss program can help you lose more excess weight in the months leading up to your surgery.
Committing to undergo bariatric surgery also means committing to lifelong lifestyle changes. After weight loss surgery, people cannot eat the same portions, have to completely remove high-sugar desserts and soda from the diets, quit smoking, and take bariatric vitamins and minerals every day. While you may have tried to accomplish some of these in the past, it’s important that you really stick after having surgery. This ensures you have the best health outcomes and can maintain weight loss long-term.
Building a lot of these new healthy habits take some time. Taking a few months prior to surgery to really get these habits down-pat is important. And typically, even if you’re not intentionally trying, it will cause weight loss too. It might even help you lose more after WLS as well. One study found that maintaining these important diet, exercise, and behavior changes during the first few years after weight-loss surgery provided an average 14% greater amount of body weight loss1.
It was thought for many years that weight loss before bariatric surgery could improve postoperative outcomes. These are things like minimizing post-op complications, decreasing surgery time, or minimizing the amount of time someone recovers in the hospital. It seems that this might not be as effective as once thought, or it might be more pertinent for individuals with very high BMIs (body mass index). Research seems to favor the short-term liver shrink diet for improving these outcomes, rather than long-term weight loss. That being said, having a lower BMI prior to bariatric surgery can only help.
Yep, depending on your insurance provider, weight loss might be a prerequisite to getting gastric bypass or other types of bariatric surgery. Most do not require weight loss itself but do require proof that you went to education sessions, attempts at healthy lifestyle changes, and attending medical appointments.
Whether or not insurance providers should require weight loss before surgery is a heavily debated topic among healthcare professionals. Many agree that this can be an unnecessary barrier to surgery.
In the end, there are very few down-sides to healthy weight loss prior to surgery. It seems that it provides possible opportunities to help lose more weight, improve outcomes, avoid weight gain, and continue healthy habits after bariatric surgery. It can only help, and if it helps even a little, why not try?
1. Tewksbury C, Williams NN, Dumon KR, Sarwer DB. Preoperative Medical Weight Management in Bariatric Surgery: a Review and Reconsideration. Obes Surg. 2017;27(1):208-214. doi:10.1007/s11695-016-2422-7
2. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by american association of clinical endocrinologists/american college of endocrinology, the obesity society, american society for metabolic & bariatric surgery, obesity medicine association, and american society of anesthesiologists - executive summary. Endocr Pract. 2019;25(12):1346-1359. doi:10.4158/GL-2019-0406
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