Preoperative Nutritional Management of Patients with Morbid Obesity

ABSTRACT

Since patients with morbid obesity undergoing bariatric surgery are vulnerable to micronutrient deficiencies, close monitoring and supplementation are necessary. The importance of screening prior to surgery has increased in recent studies; preoperative screening is recommended for thiamine, vitamin B12, vitamin D and calcium, vitamin A, E, K, folic acid, and iron. Though preoperative weight loss (PWL) of more than 10% excess body weight may be beneficial for postoperative weight loss and shorter operative time, insurance-mandated PWL before bariatric surgery is not evidence-based, unsafe, and therefore strongly discouraged. Very-low-calorie diet (VLCD) in liquid form is recommended as a safe and effective way to lose weight preoperatively. Also, screening and correction of eating disorder and psychiatric problems prior to surgery contribute to better outcome.