study to evaluate effectiveness of a weight loss program in obese patients during 3 months prior to bariatric surgery

Conditions: Obesity, Morbid; Bariatric Surgery; Comorbidity

Summary: prospective multicenter observational clinical study on a dietary regimen in obese patients scheduled for bariatric surgery.

study population: 25 patients with morbid obesity (bmi ≥ 40 kg / m2) or severe obesity (bmi 35 to 39.9 kg / m2) , with two or more comorbidities, scheduled for bariatric surgery within 3 months, and who will start treatment with the multidisciplinary weight loss program (pnk method) based on diet, exercise and psychological support. patients will be followed-up for 3 months, with the following controls: pre-selection, baseline, month 1, month 2, month 3, and control when hospital discharge. the treatment schedule in these patients will be as follows: a very low calorie ketogenic diet for at least 1 month or until losing 10% of the weight, and then, a low calorie diet with gradual reintroduction of natural foods for 2 months, until surgery. the investigators will obtain retrospective data from 25 patients treated with the standard diet who met the same inclusion/exclusion criteria as the patients in this study and who similarly resemble in age, sex and bmi, for comparative analysis (control group).

Eligibility criteria:
inclusion criteria: * patients of both sexes, between 18 and 65 years old * patients with morbid obesity (bmi ≥ 40 kg/m2) or with severe obesity (bmi 35 to 39.9 kg/m2), with two or more comorbidities associated with obesity (type 2 diabetes mellitus, arterial hypertension, obstructive sleep apnea, obesity hypoventilation syndrome, chronic respiratory disease, metabolic syndrome, atrial fibrillation, heart failure, pulmonary hypertension, cardiomyopathy, history of thrombosis, renal failure). * patients scheduled for bariatric surgery within 3 months ± 1 week. * patients who, regardless of their inclusion in this study, will undergo treatment with the multidisciplinary slimming program in study or standard diet. * patients who agree to participate and sign the informed consent exclusion criteria: * pregnant or lactating women. * patients with type 1 diabetes mellitus or on insulin therapy * patients with eating disorders, alcoholism, and/or drug addiction. * patients with any severe psychological disorder (eg schizophrenia, bipolar disorder). * patients receiving dicumarinic anticoagulants (sintrom®) or cortisone. * patients with liver failure. * patients with severe kidney failure (gfr \<30). * patients with hemopathies. * patients with cancer. * patients with cardiovascular or cerebrovascular disease (heart rate disorders, recent infarction \[\<6m\], unstable angina, decompensated heart failure, recent stroke \[\<6m\]). * patients in acute attack of gout. * patients with renal lithiasis verified by ultrasound. * patients with cholelithiasis verified by ultrasound. * patients with depression. * patients with electrolyte imbalance, according to medical criteria. * patients with orthostatic hypotension. * patients with contraindications to surgery

Keywords: pnk method obesity very low calorie ketogenic diet comorbidity bariatric surgery weight loss