WL before surgery

[Guest guest]

Do any other bariatric centers require a specific weight loss, like

5% BW prior to surgery? Very curious to find out. The main reason is

we just hired a new RN who is also a RNY post-op and is being very

critical of how we run our program. She states that she would not

have gone through our program because we have our patients jump

through too many hoops. The program where she had her surgery did

not have her do anything pre-op and she only saw a RD 1x. Granted,

she has lost a lot of weight and looks great, she has an atrocious

diet. I would not want our patients to see what she eats!

We require a 5% wl prior to scheduling a surgery date. Usually our

patients can do this while waiting for insurance approval. After the

weight loss is achieved, insurance is approved and a surgery date is

set, we start a VLCD for 2 weeks.

We have been doing it this way for 2 years with very good results,

yet not a lot of numbers, obviously. Only between 60-70 surgeries

(RNY and AGB). We pride ourselves on being a strict comprehensive

program and our post-ops all agree that they are glad they learned

how to take care of themselves before surgery. In fact, I tell my

patients that " you can't perform a play or win a game without

practicing. " I have our patients " practice " like they have a pouch

and only eat foods that they will be able to tolerate after surgery.

Usually, eating that way provides a 5% weight loss very quickly. I

also have them weigh-in at our office every 2 weeks and bring food

journals, which I review and chart on. Our surgeon relies heavily on

my report of how well a patient is doing with my diet protocols.

I really would like to know other RD's view on this. Is this being

too strict? I know that there is no sound research that states a WL

prior to surgery is an indication of post-op success. I just can't

believe that it would not help.

I would appreciate any opinions.

Thanks.

, RD, CD