In overweight or obese patients, does weight loss before surgery provide benefits? This study from the University of Leicester shows that despite frequent postponements of interventions on patients with obesity, weight loss does not have any particular effect in this case. On the other hand, the study, presented in the British Journal of Surgery, calls on health personnel too, and where appropriate, to stop all stigmatization of overweight patients.

 

Many obese and overweight patients are delayed in various surgeries until they have lost weight through diet and exercise. Yet these imposed preoperative weight loss interventions do not appear to be associated with reductions in morbidity or mortality during and after surgery.

 

This systematic review and meta-analysis of data from clinical trials and cohort studies conducted on the effect of weight loss interventions (calorie restriction diets with or without an exercise program) on the clinical outcomes of patients undergoing surgery considered 30-day in-hospital and all-cause mortality data. Postoperative thromboembolic complications, duration of surgery, incidence of infection and length of hospital stay were also considered. Thus, the analysis ultimately focused on a total of 6,060 patients.

 

 

Pre-operative weight loss does not reduce the post-operative mortality rate: the analysis indeed suggests that,

• preoperative weight loss programs are very effective for weight loss (estimated on average at more than 7 kilos),
• but not on the risk of post-op death;
• on the other hand, patients in the weight loss group benefited from a shorter hospital stay (by 27% on average);
• no difference is identified for morbidity.

 

 

Thus, the analysis suggests that preoperative weight loss has benefits , but does not alter the risk of postoperative morbidity or mortality. The health benefits of this preoperative weight loss are not significant enough to reduce the risk of death during and after surgery in patients with clinically significant obesity.

In contrast, lead author Dr Marius Roman from the University of Leicester suggests a relatively common stigma associated with obese patients in healthcare.