Energy balance
Inpatient very-low-calorie diet (VLCD) at 5 kcal/kg/day for approximately 20 weeks significantly reduces liver size and abdominal adipose tissue, thereby minimizing surgical risks and enabling successful bariatric surgery in patients with extreme obesity (BMI ≥ 50 kg/m²).
If you have extreme obesity (BMI 50+), standard dieting often fails to reduce surgical risks enough for safe operation. This protocol suggests a supervised, inpatient very-low-calorie diet (5 kcal/kg/day) for about 20 weeks. This drastic measure shrinks the liver and fat, making surgery much safer, even without exercise or drugs. It is a high-commitment bridge to a life-changing surgery.
With treatment on an inpatient basis, it is possible to maintain a controlled environment with a very-low-calorie diet, enhancing substantially the probability of achieving successful postoperative weight loss... the achieved weight loss with a 5 kcal/kg/day diet was 19%, even in the absence of drug treatment or physical activity... The goal of preoperative hospitalization is not to achieve the greatest possible weight loss, but rather to attain sufficient weight reduction to minimize surgical risks.
Why this rating
Based on a small retrospective analysis (n=20) and case examples; lacks large-scale RCTs specifically for extreme obesity bridging.
Source
Challenges in the care and treatment of patients with extreme obesity
Matheo Augusto Morandi Stumpf et al. · Archives of Endocrinology and Metabolism · 2024
DOI 10.20945/2359-4292-2023-0335
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