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Evidence Base for Optimal Preoperative Preparation for Bariatric Surgery: Does Mandatory Weight Loss Make a Difference?
Abstract
Purpose of review Preoperative weight loss regimens prior to bariatric surgery have been a routine and common practice for many centers, in the US and around the world. The mandated participation in such programs has largely been influenced by loco-regional payer requirements. The relationship between adherence to a mandatory weight loss regimen and achieved preoperative weight loss as well as the clinical impact of preoperative weight loss on bariatric outcomes remains uncertain. Recent findings This review examines the available current literature, in the context of previous findings, regarding the impact of mandated preoperative weight loss regimens and mandatory weight loss on bariatric outcomes. The reviewed studies do not provide sufficient evidence that mandatory participation in a preoperative weight loss regimen prior to bariatric surgery is associated with achieved weight loss or durable bariatric outcome benefit. Preoperative weight loss, when achieved, may confer a positive benefit on postoperative complications; however, this is not a consistent finding in the literature and requires further validation. The practice of mandating participation in a preoperative weight loss regimen or requiring mandatory weight loss prior to bariatric surgery is not supported by current literature and may serve as an obstacle to medically necessary and potentially life-saving treatment.
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Many public and private health insurers either do not provide coverage or have substantive limitations in coverage of metabolic surgery, including criteria with limited or no clinical evidence.
“For example, many public and private health insurers either do not provide coverage or have substantive limitations in the coverage of metabolic surgery, including fulfilment of a number of criteria for which there is limited or no clinical evidence46,47.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [46]
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Sorted by citations
Joint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0803-x · Cited by 1,152
“For example, many public and private health insurers either do not provide coverage or have substantive limitations in the coverage of metabolic surgery, including fulfilment of a number of criteria for which there is limited or no clinical evidence 46, 47 .”
Background
Metadata
- Authors
- Kim, J. J.
- Affiliations
- Mount Auburn Hospital (US)
- Corresponding author
- Kim, Julie J.
- ORCID
- Kim, Julie J.
- Venue
- Current Obesity Reports
- Published
- 2017-07-28
- Volume
- 6
- Issue
- 3
- Pages
- 238-245
- ISSN
- 2162-4968 (ISSN-L)
- OpenAlex
- W2741077341
- Cited by
- 25
- References
- 8
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 6 · 2019: 2 · 2018: 2
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Obesity Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Keywords
- bariatric surgery, preoperative weight loss, preoperative preparation, postoperative complications
- MeSH terms
- Humans, Obesity, Morbid, Weight Loss, Treatment Outcome, Bariatric Surgery, Preoperative Period
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