Efficacy of a liquid low-energy formula diet in achieving preoperative target weight loss before bariatric surgery.

Abstract

A preoperative weight loss of 8% is a prerequisite to undergo bariatric surgery (BS) in Denmark. The aim of the present study was to evaluate the efficacy of a 7- or an 11-week low-energy diet (LCD) for achieving preoperative target weight before BS. A total of thirty obese patients (BMI 46·0 (sd 4·4)kg/m(2)) followed an LCD (Cambridge Weight Plan(®), 4184kJ/d (1000kcal/d)) for 7 or 11 weeks as preparation for BS. Anthropometric measurements including body composition (dual-energy X-ray absorptiometry), blood parameters and blood pressure were assessed at weeks 0, 7 and 11. At week 7, the majority of patients (77%) had reached their target weight, and this was achieved after 5·4 (sem 0·3) weeks. Mean weight loss was 9·3 (sem 0·5)% (P<0·01) and consisted of 41·6% fat-free mass (FFM) and 58·4% fat mass. The weight loss was accompanied by a decrease in systolic and diastolic blood pressure (7·1 (sem 2·3) and 7·3 (sem 1·8)mmHg, respectively, all P<0·01) as well as an improved metabolic profile (8·2 (sem 1·8)% decrease in fasting glucose (P<0·01), 28·6 (sem 6·4)% decrease in fasting insulin (P<0·01), 23·1 (sem 2·2)% decrease in LDL (P<0·01), and 9·7 (sem 4·7)% decrease in TAG (P<0·05)). Weight, FFM and fat mass continued to decrease from week 7 to 11 (all P<0·01), whereas no additional improvements was observed in the metabolic parameters. Severely obese patients can safely achieve preoperative target weight on an LCD within 7 weeks as part of preparation for BS. However, the considerable reduction in FFM in severely obese subjects needs further investigation.