Multimodal approach utilising a weight management programme prior to bariatric surgery in patients with BMI ≥50 kg/m²: A propensity score matching retrospective cohort study

Summary We evaluated preoperative weight loss and days from initial consult to surgery in patients with BMI ≥50 kg/m 2 who were and were not enrolled in medical weight management (MWM) prior to laparoscopic sleeve gastrectomy. We retrospectively identified patients with BMI ≥50 kg/m 2 who had primary sleeve gastrectomy between 2014 and 2019 at two bariatric surgery centres in our healthcare system. Patients presenting after 2017 that received preoperative MWM ( n = 28) were compared to a historical cohort of non‐MWM patients ( n = 118) presenting prior to programme initiation in 2017 on preoperative percent total body weight loss (%TBWL) and days from initial consult to surgery. A total of 151 patients (MWM, 33; non‐MWM, 118) met inclusion criteria. BMI was significantly greater in MWM versus non‐MWM ( p = .018). After propensity score matching, median BMI at initial consult in non‐MWM versus MWM no longer differed ( p = .922) neither were differences observed on the basis of weight, age, sex, race or ethnicity. After PSM, MWM had significantly lower BMI at surgery ( p = .018), lost significantly more weight from consult to surgery ( p < .001) and achieved significantly greater median %TBWL from consult to surgery ( p < .001). We noted no difference between groups on 6‐month weight loss ( p = .533). Days from initial consult to surgery did not differ between groups ( p < .863). A preoperative MWM programme integrated into multimodal treatment for obesity in patients with a BMI ≥50 kg/m 2 resulted in clinically significant weight loss without prolonging time to surgery.