Implementation of a very low calorie diet program into the pre-operative model of care for obese general elective surgery patients: Outcomes of a feasibility randomised control trial

摘要

Aim: The present article aimed to evaluate the feasibility of implementing a very low calorie diet (VLCD) weight loss program into the pre-operative model of care for elective general surgery patients with obesity. Methods: A prospective, randomised control trial of adults with obesity awaiting elective general surgery was conducted at an outpatient clinic at a tertiary hospital. Patients were randomised to the intervention group, an 8-week VLCD program incorporating Optifast (Nestle Health, Germany) shakes, or to standard care (generic healthy eating information). Data were collected at baseline, week 8 and at 30 days post-surgery. The primary outcome of the study was feasibility, which was evaluated through demand, practicality, integration and acceptability measures. Results: Forty-six participants (M 17: F 29, mean age 51.6 (13.1) years) with a mean body mass index > 30 kg/m2 (40.5 kg/m2 (5.9)) were recruited. Of participants who completed the study there was a higher mean weight loss in the intervention group compared to the control group (-6.5 vs +0.15 kg; P = <.001), with no excessive loss of muscle mass (MM), measured by bioelectrical impedance analysis. The reduction in waist circumference was greater for the intervention compared to control group (-6.11 vs +1.36 cm; P = .003). Quality of life increased significantly in the intervention group (P < .001). Conclusions: The pre-operative VLCD program produced clinically meaningful rapid weight loss pre-surgery and improved quality of life without an excessive loss of MM.