Background: Very low-calorie diets (VLCD) of fewer than 800 calories per day have been widely utilized in bariatric surgery. There has been a belief that preoperative VLCD weight loss may predict the success of postoperative loss. Only one previous study has specifically assessed adult VLCD weight loss preceding laparoscopic adjustable gastric banding (LAGB). We undertook a review of our database of patients who underwent LAGB surgery in order to assess the effect of a dedicated preoperative VLCD on postoperative weight loss in adults.
Methods: Patients who underwent LAGB surgery between 2004 and 2006 were identified. A retrospective review of prospectively collected data at 12 and 36 months was undertaken, with the data then analyzed. A total of 299 patients were eligible for inclusion. Of these, 158 patients were excluded, leaving 141 patients for analysis: 36 on a preoperative VLCD and 105 controls.
Results: There was a median preoperative weight loss of 7.8±4.0 kg in the VLCD group. At 12 months after surgery, there was a significant negative effect of a preoperative VLCD (p<0.01) when comparing percentage excess weight loss (%EWL) of 38.2% for the VLCD group with 47.1% of the control group. There was no significant difference in the %EWL of the two groups at 36 months.
Conclusion: The results of this study in patients undergoing bariatric surgery using the LAGB show a negative effect on short-term weight loss postoperatively.