Prospective assessment of nutrition and exercise parameters before body contouring surgery: optimizing attainability in the massive weight loss population.

[BACKGROUND] A lower body mass index at the time of body contouring surgery can optimize surgical options and, ultimately, aesthetic results. With increased emphasis on preoperative evaluation of the massive weight loss patient, the interrelationships between nutrition and exercise on body mass indices have not been well defined.

[METHODS] One hundred thirty-three consecutive massive weight loss patients presented for body contouring. Two-week food logs, weekly exercise regimens, and body mass indices were measured. Outcome variables were assessed by univariate and multivariate analysis.

[RESULTS] One hundred fifteen women and 18 men presented, with a mean age of 46.5 +/- 11.0 years, a maximum body mass index of 52.8 +/- 10.6 kg/m2, current body mass index of 32.4 +/- 8.6, change in body mass index of 20.4 +/- 6.5, daily protein intake of 56.9 +/- 18.5 g, and mean exercise of 3.7 days/week. The mean change in body mass index for the bariatric surgery group was 20.9 +/- 6.4 versus 15.9 +/- 6.8 for the self-weight loss group (p = 0.01). Age correlated directly with current body mass index (p = 0.0031) and inversely with exercise (p = 0.0003). Change in body mass index was related to younger age (p = 0.0455), maximum body mass index (p < 0.0001), and bariatric surgery (p = 0.0016), but not protein intake. Exercise five or more times per week was associated with a larger change in body mass index and lower current body mass index (p < 0.0036) than exercising two or fewer times per week (p = 0.0292).

[CONCLUSIONS] Frequent exercise optimizes body mass index at the time of presentation for body contouring surgery. Further evaluation of the elements of diet will be required to determine its role. Thus, comprehensive post-bariatric surgery or lifestyle programs that promote exercise may increase surgical options and optimize results in body contouring surgery.