To find out if losing weight before having surgery improves surgical outcomes and helps patients keep the weight off after surgery.

Patients can wait for two years or more for their surgery. This is a long time, and their health is getting worse during this wait, which may mean they are less ready for their surgery when the time comes. Living with obesity may make the surgery more difficult for the surgeon, increases risks, and patients may recover more slowly. Losing weight before surgery could have many benefits, from getting the surgery quicker and better recovery, to lowering the risk of heart disease and death. Although living with obesity increases the risks linked to surgery, there are many things we don’t know about losing weight before surgery:

1. Whether offering support to lose weight before surgery helps patients to lose weight and keep it off.
2. Whilst we know that living with obesity is riskier for surgery, we don’t know if the risks are reduced if patients lose weight directly before surgery.
3. If patients benefit equally from support, especially if people live in a poorer area as they are more likely to be living with obesity and have other health problems that may affect their surgery.

We will investigate these key questions to improve care for people living with obesity and reduce inequalities by helping people lose weight. If patients lose weight, they might be able to go to treatment centres/private hospitals for their treatment, as they are lower risk, meaning more equal access to surgery and benefit those most in need.

1. We will use data already collected about patients that have had surgery and see if weight loss before surgery improved recovery and if they kept the weight off over five years. We will look at patients from diverse backgrounds and surgery types. This will help to target types of surgery where weight loss may be best.
2. We will interview patients, health care teams and people who deliver weight loss programmes to identify which weight loss programme(s) should be offered to patients before surgery. We will then come together as a larger team to decide which programmes we should test. We will not create a new programme, instead use ones already available.
3. We will test the programme(s) and randomly (like tossing a coin) give participants a weight loss programme or a leaflet about healthy living before surgery to see if patients are willing to take part and able to lose weight.
4. We will combine data from my trial with data from other similar trials and also combine data on NHS services that are offering weight loss before surgery. We will then be able to provide policy makers with evidence about weight loss before surgery.

You can take part in many ways, and we would love to hear from you. This research is about the experiences and views of those who have lived through this. Your views matter and will inform policy guidance. You can take part by:

1. Helping design and analyse the research, sharing your experiences.
2. Take part in interviews to tell us about your experiences and views – contact details are below.
3. We are very interested in collaborating, if you are a researcher or clinician do, please get in touch. We like working with good people to improve the population's health.

Dr Claire Madigan

c.madigan@lboro.ac.uk

+44 1509 223008

Twitter: @claire_WM

Mentors for this study: 

• Professor Amanda Daley 
• Professor Kamlesh Khunti
• Professor Gavin Murphy
• Dr Charlotte Albury

Supported by:

• ARC East Midlands
• National Rehabilitation Centre 
• Leicester Biomedical Research Centre
• Real World Evidence Unit
• Centre for Ethnic Health Research
• Leicester Clinical Trials Unit

Collaborators:

• ARC North East North Cumbria 
• Professor Franco Carli
• Dr James Prentis
• Professor Thomas Pinkney
• Professor Paul Baker