ClinicalTrials.gov identifier: NCT00623792.
Article first published online: 26 MAR 2013
Copyright © 2012 The Obesity Society
Volume 21, Issue 2, pages 254–260, February 2013
How to Cite
Kalarchian, M. A., Marcus, M. D., Courcoulas, A. P., Cheng, Y. and Levine, M. D. (2013), Preoperative lifestyle intervention in bariatric surgery: Initial results from a randomized, controlled trial. Obesity, 21: 254–260. doi: 10.1002/oby.20069
Disclosure: The authors have no conflicts of interest.
Funding agencies: R01DK077102 from the National Institute of Diabetes and Digestive and Kidney Diseases (PI: Melissa A. Kalarchian).
- Issue published online: 26 MAR 2013
- Article first published online: 26 MAR 2013
- Accepted manuscript online: 3 OCT 2012 10:52AM EST
- Manuscript Accepted: 3 AUG 2012
- Manuscript Received: 28 FEB 2012
To document preoperative outcomes of a behavioral lifestyle intervention delivered to patients prior to bariatric surgery in comparison to treatment as usual (insurance-mandated physician supervised diet).
Design and Methods:
After completing a baseline assessment, candidates for surgery were randomized to a 6-month, evidence-informed, manualized lifestyle intervention (LIFESTYLE, n = 121) or to preoperative care as usual (USUAL CARE, n = 119). At 6 months, 187 participants remained candidates for bariatric surgery and were included in the analyses.
LIFESTYLE participants lost significantly more weight than those receiving USUAL CARE [8.3 ± 7.8 kg vs. 3.3 ± 5.5 kg, F(1,183) = 23.6, P < 0.0001], with an effect size of 0.72. Additionally, logistic regression modeling indicated that LIFESTYLE patients were significantly more likely to lose at least 5% of initial body weight than those in USUAL CARE [OR (95% CI) = 2.94 (1.253, 6.903)], as were participants who were heavier [OR (95% CI) = 1.07 (1.001-1.14) for each unit increase in BMI] or with larger improvements in eating behaviors [OR (95% CI) = 1.1 (1.049, 1.145) for each unit increase on the Eating Behavior Inventory).
A behavioral lifestyle intervention for severely overweight individuals leads to clinically significant weight loss prior to bariatric surgery. Post-surgery follow-up will allow us to examine the impact of the preoperative intervention on postoperative outcomes.