Current preoperative strategies applied in the Dutch bariatric centers: A national survey

Abstract

There is no consensus about the optimal management of patients undergoing bariatric surgery. This study aimed to identify current weight loss goals prior to bariatric surgery, as well as aimed to explore preoperative strategies related to diet, nutritional supplements and physical activity. An online survey was distributed among bariatric surgeons and dietitians in all 18 Dutch bariatric centers. This survey included the following four domains: weight loss, diet, nutritional supplements and physical activity.For the analyses one answer per center was used, either the most common answer or the answer given by the most expert responder. All 18 centers reported at least one response. Preoperative weight loss was requested in 28% of the centers, whereas 61% desired a stable weight or weight loss, and 11% had no requests. A preoperative diet was routinely recommended in 78% of the centers and on indication (ie, depending on baseline weight and/or comorbidity status) in 22%. The most frequently prescribed diet was a low-energy diet (800-1500 kcal/day) in 44% of the centers. Nutritional supplements were recommended in 78% of the centers. Physical activity with low intensity was recommended in 83% of the centers, while physical exercise training with mid-to high-intensity was recommended in 72%. Inconsistent responses within centers were observed in 56% of the questions. The current bariatric practice within the Netherlands shows high variability and inconsistencies in preoperative management. Consensus-building and standardization of strategies should be promoted in the future.

Variation and outcomes of liver-reducing dietary regimens before bariatric surgery: a national retrospective cohort study

“…There is high variability in how LRDs are delivered within and between multiple countries across the world [15][16][17][18]. This reflects the lack of conclusive evidence on the most optimal type, content, or duration of LRD [19], resulting in European [20] and US [21] clinical practice guidelines being unable to make evidence-based recommendations on the delivery of LRDs.…”

The Peripheral Kynurenine Pathway and Psychosomatic Comorbidity in Subjects with Morbid Obesity Undergoing Bariatric Surgery

“…There was a conservative lifestyle intervention for six months and an energy-restricted diet in the last weeks before surgery. Surgery was performed with accepted methods, and there was a follow-up six months after surgery [39,40]. The psychosomatic symptoms were registered with validated questionnaires.…”