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Bariatric Surgery

The effect of preoperative body weight loss on 5-year bariatric surgery outcomes

International Journal of Obesity volume 49, pages 1717–1722 (2025)Cite this article

Subjects

Abstract

Objectives

This study aimed to evaluate the effect of preoperative total body weight loss (TBWL) following a structured 6-month lifestyle change programme (LCP) on the level of TBWL at 12 months and its maintenance at 60 months post bariatric surgery (BS), as well as its impact on operation time, hospital stay, surgical complications and obesity-associated pathology remission.

Methods

This retrospective, single-centre study analysed patients undergoing primary BS between 2013 and 2014. Outcomes were compared between patients participating in the LCP (LCP group) and those receiving standard preoperative education (Control group: CG). Data collected included anthropometric measurements, obesity-related pathologies, surgical complications, and weight-related outcomes.

Results

Among 340 BS procedures performed, 165 patients met the inclusion criteria; 59 in the LCP group and 106 in the CG. The mean age was 47 ( ± 11.6) years in the LCP group and 45 ( ± 11.1) years in the CG with no significant differences in baseline clinical characteristics. At surgery, the LCP group showed significant weight reduction (–5.9 kg vs. –0.72 kg in controls, p = 0.008) and their BMI was significantly lower (46.55 vs. 49.47 kg/m², p = 0.002). Postoperatively, weight-related outcomes [BMI and TBWL] were better in the LCP group at 1 and 5 years. Additionally, patients achieving a preoperative TBWL > 5% demonstrated a significantly lower weight and BMI, along with a higher postoperative TBWL. Surgical complications were minimal, with no significant differences in 30-day complication rates. We did not observe a greater resolution of comorbidities in patients who participated in the LCP or those who achieved a preoperative TBWL ≥ 5%.

Conclusions

While current evidence suggests that preoperative TBWL provides short-term benefits, our data suggest this may also be the case for TBWL in the long-term. Further research is needed to fully elucidate the role of preoperative TBWL in comorbidity resolution in BS patients.

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Data availability

The data that support the findings of this study are no publicity available due to their containing information that could compromise the privacy of research participants, but are available from the corresponding author (LF, lflores@clinic.cat).

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Acknowledgements

We wish to express our sincere gratitude to Lucía Rodríguez, whose participation was fundamental to the development of this study. Although she has since retired, her contributions continue to have a lasting impact on the field and, Sonia Diestro for her assistance in statistical analysis.

Funding

This study was supported by a donation from the non-profit Roviralta Foundation.

Author information

Authors and Affiliations

  1. Endocrinology and Nutrition Department, Obesity Section, Hospital Clinic, Barcelona, Spain

    L. Flores, A. Andreu, M. Claro, J. Molero, A. Jiménez & J. Vidal

  2. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain

    L. Flores & J. Vidal

  3. Institut d’Investigacions Biomèdiques August Pi Sunyer IDIBAPS, 180, Corcega Street, 08036, Barcelona, Spain

    L. Flores, R. Olbeyra, J. Ríos, A. Jiménez & J. Vidal

  4. Centro de Investigación Biomédica en Red de Obesidad y Nutrición (CIBEROBN), Barcelona, Spain

    A. Andreu & A. Jiménez

  5. Psychiatry and Psychology Department, Obesity Unit, Hospital Clinic; Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain

    S. Cañizares

  6. Clinical Pharmacology Department, Hospital Clinic and Medical Statistics Core Facility, Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    J. Ríos

Authors
  1. L. Flores
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  9. J. Vidal
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Contributions

LF, AA, RO, and JV conceived the study, participate in collecting data, contributed to discussion and wrote the manuscript. SC, MC, JM, AJ participated in collecting data and contributed to the discussion. RJ: performed the statistical analysis. All authors read and approved the final manuscript. LF is the guarantor of this work.

Corresponding author

Correspondence to L. Flores.

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The authors declare no competing interests.

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Supplementary information

41366_2025_1794_MOESM1_ESM.docx (download DOCX )

Supplementary 2: Comparison of body weight-related variables for patients who achieved preoperatively less than 5% or more than 5% TBWL. Supplementary 3. Total body weight loss according achieve preoperative greater than 5% of total body weight loss and for sex

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Flores, L., Andreu, A., Olbeyra, R. et al. The effect of preoperative body weight loss on 5-year bariatric surgery outcomes. Int J Obes 49, 1717–1722 (2025). https://doi.org/10.1038/s41366-025-01794-6

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