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

Abstract 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 23, mean age 51.6 (13.1) years) with a mean body mass index ≥ 30 kg/m 2 (40.5 kg/m 2 (5.9)) were recruited. There was a higher mean weight loss in the intervention group (n = 23) compared to the control group (n = 14) (−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 (n = 21) compared to control group (n = 5) (−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.