Making Weight For Surgery

Getting into the right weight range is probably the next most important preparation for surgery after quitting nicotine. 

Being overweight increases the risks of communications and frequently also stops the patient from getting the best cosmetic result.

Using the Body Mass Index (a ratio of the body weight to the height) as a guide, I certainly want all my surgical patients to be in the non obese range of BMI of less than 30 and below 25 (normal weight) if possible.

Many of my patients would have tried various diets and meal plans in the past. And the familiar account is that of initial weight loss and then hitting a plateau and often regaining.

Our weight management coaching for pre-surgery patients routinely consists of a detailed assessment of dietary patterns and lifestyle to identify obvious tweaks such as reducing alcohol intake and added sugar. I remember a patient who used to drink only Lucozade and that was an easy fix.

In addition to conventional strategies like cutting down on added sugars, choosing lower glycaemic index foods and increasing activity level, more latterly we have been suggesting a trial of short intermittent fasting.

Much has been written on the benefits of fasting. In the main, fasting helps reduce insulin resistance and elevated insulin level (which enhances fat storage rather than loss) and obviously helps with reducing fooid intake.

A easy programme to adopt is the 16:8 routine. Essentially this involves fasting for 16 hours after the last evening meal which translates into skipping breakfast and delaying lunch (for some). Most people get used to not eating breakfast (unsweetened drinks allowed) very quickly and through that learn that we do not need to feed constantly or frequently. Depending on the target to be achieved, meals during the 8 feeding hours can be as normal or modified, mostly to reduce added sugars and control total intake.

This approach produces a less dramatic weight loss than, say, a very low calorie diet using meal replacments. However it is potentially sustainable long term which is probably the biggest challenge in weight management.

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