Losing Weight Prior to Bariatric Surgery May Help Obtain Your Best Result

Every week I see patients who have been operated on at other programs only to gain back much of their weight or disappointed with the amount of weight they have lost. Often people had their operation when their weight was considerably more than a BMI of 55. (That would be more than 355 lbs for a person that is 5 foot 7 inches tall.)

This is the message:

Gastric bypass and gastric sleeve operations help people lose weight for only about one year.

After the first year the operation is likely to help the patient to maintain their weight at about the same level but it is unlikely that they will lose more weight from the operation.

Whatever a person’s weight is one year after a gastric bypass or gastric sleeve operation is at 1 year after the operation is likely to be about near their best weight.

That is why we choose to make sure each patient is no more than a BMI of 55 prior to surgery. This can be done with dietary changes, medications and/or a physician supervised very low carbohydrate diet.

Shifting the curve I drew for you downwards, (note the purple arrow pointing down), before surgery is the way to obtain the best result after surgery.



The weight loss curve is about the same regardless of how much excess weight someone has. Although there may be the occasional exception, the most a patient is likely to lose after a gastric bypass or gastric sleeve operation is about 170 to 200 lbs. That means if you have 300 to 400 lbs of excess weight you are still likely to have 200 lbs of excess weight after surgery. This is why we encourage our patients to "shift the curve" downward to a BMI of 55 if their weight exceeds this number. Then after surgery they are much more likely to lose nearly all of their excess weight and approach ideal weight and resolve many of their obesity related medical problems.

These are the benefits of reaching a BMI of 55 or less before surgery.

Better results
Weight reaches near Ideal weight at 1 year
Better resolution of obesity related medical problems
Less complications
Less likely to need a tracheostomy
Less likely to need to need ICU stay
Less likely to have skin or muscle breakdown from being in bed after surgery

This is the bottom line:
Safer operation with better results

Posted by Stephan Myers, MD, FACS, Bariatric Surgeon, Columbus , Ohio