Published online Dec 15, 2022. doi: 10.4239/wjd.v13.i12.1096
Peer-review started: July 21, 2022
First decision: September 4, 2022
Revised: September 9, 2022
Accepted: November 2, 2022
Article in press: November 2, 2022
Published online: December 15, 2022
Processing time: 147 Days and 4 Hours
Bariatric surgery offers the best health results in overweight and obese patients but is not a risk and/or complication-free treatment. In cases with additional hyperglycemia, the burden of surgery can be even higher and alter both short-term and long-term outcomes. Although bariatric surgery offers glycemic improvements and in the case of early onset diabetes disease remission, weight loss results are lower than for obese patients without diabetes. Different multimodal programs, usually including interventions related to patients’ performance, nutritional and psychological status as well as currently available pharmacotherapy before the surgery itself might considerably improve the immediate and late postoperative course. However, there are still no clear guidelines addressing the prehabilitation of obese patients with dysglycemia undergoing bariatric surgery and therefore no unique protocols to improve patients’ health. In this minireview, we summarize the current knowledge on prehabilitation before bariatric surgery procedures in patients with obesity and dysglycemia.
Core Tip: The prehabilitation of bariatric surgery patients is an insufficiently investigated area of research. Adequate perioperative preparation for patients awaiting bariatric surgery could present one of the main determinants of predicting the success of surgical treatment, especially in patients with associated dysglycemia. A combination of calorie restrictive diet, structured exercise program, psychological support, and anti-obesity pharmacotherapy should be implemented in the perioperative care of candidates for bariatric procedures. This multimodal approach has the most promising potential to promote 5% weight loss at least thus affecting chronic inflammation and insulin resistance, the main culprits of bariatric surgery resistance.