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How Can Patients Prepare for Bariatric Surgery?

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How Can Patients Prepare for Bariatric Surgery?

— By Andrea M. Pampaloni, Ph.D.

Bariatric surgery is considered a final option for people with obesity who have potentially life-threatening health issues related to their weight.

With the obesity rate in the United States higher than ever, it is not surprising that the number of people having bariatric surgery also is on the rise. Bariatric surgery, including gastric bypass, sleeve gastrectomy and biliopancreatic diversion with duodenal switch procedures, is considered the final option for people with obesity who have potentially life-threatening health issues related to their weight.

Who are Candidates for Bariatric Surgery?

To be eligible for bariatric surgery, patients traditionally had to be more than 100 pounds overweight or have a Body Mass Index (BMI) greater than 40; or have a BMI greater than 35 with at least one obesity-related comorbidity. Patients also need to demonstrate that they have tried to lose weight but were unsuccessful maintaining a sustained loss.

However, in 2018 the American Society for Metabolic and Bariatric Surgery changed their position statement to recommend that patients with a lower BMI, between 30 and 35, be considered for surgery because of the health benefits they are likely to attain. This includes improvements to or remission of diabetes, hypertension and hyperlipidemia. There is also recent evidence that some patients with fatty livers can experience a significant reduction in liver and heart disease after weight loss surgery.1 Reducing the size of the liver prior to surgery has the added benefit of allowing more room for the surgeon to operate.

Utilizing a Very Low Calorie Diet to Prepare for Bariatric Surgery

As with most surgeries, pre-operative weight loss offers health benefits. Losing five to 10 percent of excess weight prior to surgery led to shorter operating time and hospital stays, and greater weight loss one year after surgery. This is important because the 18-month period following surgery is the “honeymoon period” for weight loss. After that time the body starts adapting, so continued significant weight loss is unlikely. Accordingly, it is important to incorporate lifestyle changes during that window that can become habit and therefore carry over as patients continue their weight loss journey.

To achieve this level of success and the corresponding health benefits, a Very Low Calorie Diet (VLCD), such as the medically-supervised New Direction Weight Management System, has been found to be effective in helping patients achieve sufficient weight loss prior bariatric surgery and reducing surgical risks.2 Weight loss also achieved by a VLCD also contributes to reductions in body circumference, another benefit in preparing for bariatric surgery.3

As such, the use of a VLCD as part of a program that includes medical monitoring and nutritional, behavioral, and exercise counselling complement the goals of bariatric surgery programs, while reducing risk and increasing health outcomes.



  1. Association of Bariatric Surgery with Major Adverse Liver and Cardiovascular Outcomes in Patients with Biopsy-Proven Nonalcoholic Steatohepatitis
  2. Diet Approach Before and After Bariatric Surgery
  3. Very Low-Calorie Diet in Candidates for Bariatric Surgery: Change in Body Composition during Rapid Weight Loss


About the Author: Dr. Andrea Pampaloni has over 20 years of communication experience across corporate, academic, nonprofit and government sectors. She provides research and writing services on a range of business issues and industry-specific topics to prepare white papers, articles, proposals, presentations, technical content, and speaking points, as well as marketing-communications content such as blogs, website content, newsletters, news releases and award submissions. Dr. Pampaloni’s research findings have been presented at national and international conferences and published in peer-reviewed journals, and she is a ghostwriter for three books, a Forbes article, and several corporate blogs.

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