Preoperative lifestyle intervention in bariatric surgery: Initial results from a randomized, controlled trial

Abstract

In this initial report, we document preoperative outcomes of a behavioral lifestyle intervention delivered to patients prior to bariatric surgery. Participants (N = 240) were 86.7% female, 82.9% white, 52.3% married, and 85.8% had ≥ high school education. Mean BMI was 47.9 ± 6.7 kg/m2 and age was 45.2 ± 11 years. After completing a baseline assessment, patients were randomized to a 6-month, evidence-informed, manualized lifestyle intervention (LIFESTYLE, n = 121) or to preoperative care as usual (USUAL CARE, n = 119). At 6 months, 187 participants remained candidates for bariatric surgery and were included in the analyses. Results indicated that LIFESTYLE participants lost significantly more weight than those receiving USUAL CARE [8.3 ± 7.8 kg vs. 3.3 ± 5.5 kg, F(1,182) = 23.6, p < 0.0001], with an effect size of 0.72. LIFESTYLE patients were more likely to lose at least 5% of initial body weight than those in USUAL CARE (OR = 4.98, p < 0.0001), as were participants who were older (OR = 1.04, p = 0.01 for every year increase in age) or heavier (OR = 1.06, p = 0.02 for each unit increase in BMI). A behavioral lifestyle intervention for severely overweight individuals leads to clinically significant weight loss prior to bariatric surgery. Post-surgery follow-up will allow us to examine the impact of the preoperative intervention on postoperative outcomes.