Perioperative medicine & outcomes
Preoperative low-energy diets for patients with a body mass index >30 kg/m2 undergoing non-bariatric surgery: pilot feasibility randomized clinical trial and a systematic review and meta-analysis of efficacy data
Authors' conclusion
The feasibility targets of this pilot RCT were not met for recruitment rate, randomization percentage, and complete follow-up.
Study context
- Population
- Patients aged >18 years with BMI >30 kg/m² undergoing elective non-bariatric intra-abdominal or orthopaedic surgery, four centres in Canadarandomized
- Participants
- 91 patients
- Comparison
- 3-week preoperative low-energy diet vs standard care
- LEDn = 45
- Controln = 46reference
- Outcome
- Feasibility (descriptive): recruitment rate, randomization percentage, intervention adherence, follow-up completion
Methodological detailsmulticentre, 1 : 1 randomly permuted online blocked allocation, random-effects meta-analysis, Conducted 3 January 2024 to 23 October 2024; last follow-up 14 January 2025
- Multicentre
- 1 : 1 randomly permuted online blocked allocation
- Random-effects meta-analysis
- Conducted 3 January 2024 to 23 October 2024; last follow-up 14 January 2025
Pooled result
As reported in the abstract
Feasibility outcomes
Randomization percentage (175 of 288 eligible consented to be randomized), 95% CI 54.9-66.4%
60.8%
Complete follow-up (81 of 91 randomized), 95% CI 80.7-94.6%
89%
LED adherence, 95% CI 74.1-89.3%
81.7%
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| 30-day postoperative morbidity (meta-analysis of 5 RCTs) · I2 = 0% · random-effects meta-analysis | 0.81 (0.52–1.26) | P = 0.351 | |
| 0.512Relative risk (log scale) |
| Outcome | MD (kg) (95% CI) |
|---|---|
| Weight loss during the 3-week intervention period · analysis of covariance; LED lost more weight | 4.5 (−5.6 to −3.5) |
- 30-day postoperative morbidity (meta-analysis of 5 RCTs) — Relative risk reduction favouring the intervention
- 19%
Original publication
Preoperative low-energy diets for patients with a body mass index >30 kg/m2 undergoing non-bariatric surgery: pilot feasibility randomized clinical trial and a systematic review and meta-analysis of efficacy data. Br J Surg. Published 13 March 2026. doi:10.
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