Results of a Professional Medical Counseling/surveillance in Preoperative Weight Loss

Background:Preoperative weight loss reduces the risk for complications after bariatric surgery.Objectives:To evaluate the effectiveness of a preoperative counseling program compared to general recommendations alone.Setting: Obesity Surgery Unit. Reina Sofia General University Hospital. Murcia (southeast Spain).Methods: Prospective, randomized controlled study including 162 patients. Participants were randomly assigned to our preoperative intensive behavioral/lifestyle program (Counseling Group:55, 78% women) or to receive general nutritional recommendations (Reference Group:49, 82% women). Primary endpoint was a between-group comparison of percent excess weight loss (%EWL) at 4 months.Results: Counseling Group: baseline Body Mass Index (BMI)1was 45.9±7.3kg/m2 when enrolled into the education program and reduced to to BMI2:43.2±5.6kg/m2 the day before the operation. After the motivational intervention, we got an average loss of 7.3±3.7kg of body weight and 12.4%EWL in 16 weeks.Reference Group: mean BMI1 was 45.5±7.3kg/m2. The day before surgery, BMI2 was: 46.1±6.1kg/m2. Over a period of 16 weeks the average weight gain was 1.8±1.1kg and -3%EWL (p=0.12). Weight gain was observed in 55% of these patients.The comparison of the mean %EWL in both groups did not reveal any statistically significant differences. Conclusions: The educational intervention was not statistically significant more effective than general nutritional recommendations in achieving weight loss