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Background <p>Weight loss has been shown to favorably affect obesity-related comorbid disease. Prior studies have shown that a 10% preoperative weight loss is associated with fewer complications after gastric bypass surgery. Although the optimal preoperative preparation for bariatric surgery is not standardized, prerequisite weight loss prior to bariatric surgical procedures is often mandated, typically around 10%, and includes a calorie-restrictive preoperative diet.</p> Objectives <p>To evaluate the association between extensive preoperative weight loss and perioperative outcomes in patients undergoing bariatric surgery.</p> Methods <p>To determine optimal weight loss prior to bariatric surgery, we compared patients who lost over 10% of their highest weight preoperatively to patients who did not within the MBSAQIP database from 2015 to 2021, which included over 1.3&#xa0;million patients.</p> Results <p>Patients who lost more than 10% of their highest preoperative weight were more likely to experience postoperative complications, including reoperation (1.40% vs. 1.21%, <i>p</i>&lt;.001), bleeding (0.85% vs. 0.67%, <i>p</i>&lt;.001), emergency department visits (7.11% vs. 6.57%, <i>p</i>&lt;.001), and dehydration (3.92% vs. 3.61%, <i>p</i>&lt;.001). These differences remained significant with multivariable logistic regression analysis controlling for multiple patient factors and procedure type.</p> <p>Patients who lost more than 10% of their highest preoperative weight were also found to have a higher mortality (0.10% vs. 0.08%, <i>p</i>=.04) and readmission (3.92% vs. 3.60%, <i>p</i>&lt;.001), however after multivariable logistic regression analysis these two findings did not retain their statistical significance.</p> Conclusion <p>Preoperative weight loss prior to bariatric surgery may be beneficial, however over 10% preoperative weight loss is associated with worse outcomes and should be cautioned.</p>

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Extensive Weight Loss Prior to Bariatric Surgery is Associated with Worse Outcomes

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Cody Ness,
  • Marcoandrea Giorgi,
  • John Pickering,
  • Emily Ortega-Goddard,
  • Andrew Luhrs

摘要

Background

Weight loss has been shown to favorably affect obesity-related comorbid disease. Prior studies have shown that a 10% preoperative weight loss is associated with fewer complications after gastric bypass surgery. Although the optimal preoperative preparation for bariatric surgery is not standardized, prerequisite weight loss prior to bariatric surgical procedures is often mandated, typically around 10%, and includes a calorie-restrictive preoperative diet.

Objectives

To evaluate the association between extensive preoperative weight loss and perioperative outcomes in patients undergoing bariatric surgery.

Methods

To determine optimal weight loss prior to bariatric surgery, we compared patients who lost over 10% of their highest weight preoperatively to patients who did not within the MBSAQIP database from 2015 to 2021, which included over 1.3 million patients.

Results

Patients who lost more than 10% of their highest preoperative weight were more likely to experience postoperative complications, including reoperation (1.40% vs. 1.21%, p<.001), bleeding (0.85% vs. 0.67%, p<.001), emergency department visits (7.11% vs. 6.57%, p<.001), and dehydration (3.92% vs. 3.61%, p<.001). These differences remained significant with multivariable logistic regression analysis controlling for multiple patient factors and procedure type.

Patients who lost more than 10% of their highest preoperative weight were also found to have a higher mortality (0.10% vs. 0.08%, p=.04) and readmission (3.92% vs. 3.60%, p<.001), however after multivariable logistic regression analysis these two findings did not retain their statistical significance.

Conclusion

Preoperative weight loss prior to bariatric surgery may be beneficial, however over 10% preoperative weight loss is associated with worse outcomes and should be cautioned.