Do I Really Need to Lose Weight Before Weight Loss Surgery?

Losing weight is very frustrating, and it gets even worse when a weight loss surgeon asked to lose weight before a weight loss surgery. So, what’s the point?

A successful weight loss surgery starts with preparing your body for surgery. By losing the prescribed weight prior to surgery, you are ensuring you are off to a great start and a safer surgery with shorter time in the operating room.

The patient´s pre-op weight loss compliance before surgery is as important as the surgeon´s expertise.

Here are some reasons to consider:

  • Reduced liver´s size. Carbohydrates are stored in the liver as glycogen, patient´s with a BMI higher than 30 most likely have an enlarged liver from glycogen storage, water and fat deposits. Reducing the overall size of the liver will allow the surgeon to lift the liver to access the stomach and abdominal area safely. The pre-op diet must avoid carbs and fats.
  • Lose visceral fat. While on the pre-op, in addition to a low calorie diet, it is important to increase the physical activity to promote visceral fat loss. Losing fat tissue in the abdominal area, in a short period of time, allows additional space and reduces manipulation while performing the procedure.
  • Nutrient replenishment. Though considered a state of “overnutrition”, obesity has been increasingly recognized as a risk factor for several nutrient deficiencies, likely due to higher-calorie intake of processed foods associated with poor nutritional quality and to a low intake of nutrient-dense low-calorie foods such as vegetables. The pre-operative recommendations improve the nutritional status, and reduce post-operative risk of significant nutritional deficits.
  • Preserve muscle and improve immune response. A high protein diet will help preserve and improve muscle tissue while on the pre-op. High quality protein sources with calorie controlled intake include whey protein shakes; these help improve the immune response while on the perioperative stages and aid in the healing process.

Pre-operative weight loss is associated with fewer complications, including converting the laparoscopic procedure to an open surgery.

Patients who “eat freely” before starting a pre-op diet or have a “last meal”, sabotage all efforts and may prolong their hospital stay. Patients who lose 5-10% of their pre-surgical body weight will have an overall better experience, better recovery and quicker healing.

We are talking about a surgery after all, and we all want the best outcome possible.


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OCC’s epidemiologist is closely monitoring the COVID-19 status and is actively issuing updates as they are available. The Centers for Disease Control and the World Health Organization are the most trusted sources online.  While the CDC has announced new mask protocols for vaccinated individuals, there will be no changes for our office protocols for patients, guests, and staff members as the announcement does not apply to hospitals or medical facilities. Masks are still a requirement for all patients, guests and staff at our facility.

As we reinitiate weight loss surgery, we are constantly adapting and installing new and updated safety measures.

Weight loss surgery is medically necessary.

Bariatric Surgery and the clash of two pandemics.   

Major metabolic and bariatric surgery Societies and colleges globally are now calling for the safe resumption of bariatric and metabolic surgery before the COVID-19 pandemic is declared over. 

The sooner bariatric surgery can be safely performed, the quicker obesity, type 2 diabetes, and other diseases can be reduced or resolved as they are not only chronic they are also progressive.  Obesity is also linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis, and at least 13 different types of cancer.

A recent statement from the ASMBS says “Before COVID-19 began, it was clear that patients with obesity were ‘safer through surgery.’ In the era of COVID-19, ‘safer through surgery’ for patients with obesity may prove to be even more important than before.” Obesity and Metabolic syndrome have been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients.

See here for full COVID-19 update. 

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