BackgroundControversies remain regarding the position of preoperative weight control. Orlistat, which shares a mechanism of restricting dietary fat absorption with gastrointestinal bypass procedures, has long been widely used for weight management. The aim was to assess the mutual relationship between the results of preoperative weight control with orlistat and surgical outcomes after one-anastomosis gastric bypass (OAGB).MethodsThe medical records of all consecutive patients with body mass

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... x (BMI) ≥ 42.5 kg/m2 who underwent primary OAGB from 2014 to 2020 were retrospectively reviewed. Orlistat was routinely suggested for this subgroup and prescribed 10-14 days preceding surgery. Patients were stratified into weight reduction (Group 1) and weight gain (Group 2) groups. The variables assessed included the correlation of pre- and postoperative weight change up to 3 years postoperatively and 30-day surgical outcomes.ResultsAmong 55 patients who fulfilled the inclusion criteria and were compliant with treatment, 35 (64%) patients lost a median of 2.0 kg, in contrast to a median weight gain of 2.9 kg in Group 2. Group 1 had a significantly higher BMI (48.9 kg/m2 vs. 44.6 kg/m2; p= 0.003) at the last clinic visit and included more females (54% vs. 25%) than Group 2. There was a trend of reduced surgical duration (107 min vs. 140 min; p= 0.109), with no difference in 30-day complications. Weight loss percentages between groups were not different at 24 months.ConclusionPreoperative weight loss with orlistat reduced the operation time but did not affect weight loss at 2 years.