USE OF VERY-LOW-CALORIE DIET IN PREOPERATIVE WEIGHT-LOSS - EFFICACY AND SAFETY

We report the efficacy of a very low-calorie diet (VLCD)-based weight reduction program in patients with morbid obesity whose elective surge ry had been postponed because of being overweight. The safety of weigh t loss on the immune system will also be evaluated. Thirty patients (m ean age, 50 years; weight, 125 kg; BMI, 44 kg/m(2)) were treated. The program consisted of a 7-week to 24-week VLCD period, supported by ind ividual sessions with a therapist, and of a refeeding period of 1 mont h before surgery. Two patients discontinued, and the mean weight loss of the remaining 28 patients was 19.6 kg (15% of initial weight). In 2 3 patients, weight loss was 10% or more of the initial weight. After w eight loss, 15 patients underwent surgery, 4 patients did not need an operation, and the remaining 9 patients were not operated on for vario us reasons. The numbers of circulating leukocytes, neutrophils, basoph ils, monocytes, CD3(+), CD4(+), CD8(+), and natural killer cells did n ot change significantly by the ninth week on VLCD or by the end of the program. However, there was a significant (p<0.05) decrease in the im munoglobulinM serum concentration during the program. In conclusion, a VLCD program is suitable for preoperative weight reduction in morbid obesity and seems not to compromise the immune system.