Jan - Feb 2020

Should You Lose Weight Before Your Bariatric Surgery? The Answer May Surprise You...

By Ryan Moon, MD


One important, but often overlooked part of preparing for any bariatric surgery is the amount of weight that patients lose before they even step foot into the operating room. Patients sometimes express concern over losing too much weight prior to surgery, thus eliminating eligibility or coverage from their insurance coverage. One easy solution is to ask your bariatric program staff to calculate your “floor”—or the lowest possible weight that you could attain. This often eliminates any unfounded fears.


Unfortunately, some patients view the period prior to surgery as a “last hoorah”, and actually partake in poor eating habits that they feel they may not be able to do after surgery. This flawed thought process could keep them from being successful in their weight loss journey.


Dropping a few pounds prior to surgery can usually be achieved through a dedication to a healthier, more mindful lifestyle: daily movement, eating more vegetables and lean protein, while avoiding foods and drinks which are high in sugar and lacking fiber.  This is a great time to start a journal either the old-fashioned pen and paper or an app. By working on this prior to surgery, you will be establishing the proper mindset that you will need to maximize this surgical tool.


The true impact of having surgery can be quite abrupt, in that the moment you wake up, you will need to adjust to a different style of eating and drinking. Starting the process prior to surgery will give you a significant psychological edge, and perhaps make the early part of your journey easier.  Establishing healthy eating behaviors and exercise habits will give you a head start in maintaining a routine, which will only make life easier after surgery.


The physiologic effects of weight loss are important too. Any weight loss prior to surgery helps to shrink the size of the liver. While this may not mean much to the patient, it certainly makes things easier for your surgeon. Weight loss can actually soften and shrink the liver by almost 2 to 3 cm according to the literature. Because the left lobe of the liver needs to be retracted or lifted out of the way for all bariatric procedures, losing weight helps your surgeon to see vital organs better, and makes it an overall safer procedure. It also accelerates your metabolism prior to surgery and can give your body a helping hand as you start your journey.


Also keep in mind that there’s evidence that weight loss prior to bariatric surgery can lower post-operative complications. These listed complications range from simple wound infections, to leaks, and even length of hospital stay.


So, what are you waiting for? Find those gym shoes, and start recording your calories today! Start somewhere. The clock is ticking!