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PRO:
Jennifer L. Kuk, PhD
Associate Professor, York University, School of Kinesiology and Health Science
Dr. Jennifer Kuk, PhD, is currently an Associate Professor in the School of Kinesiology and Health Science at York University. She obtained her BScHons from the University of Western Ontario, and her MSc and PhD from Queen's University with Dr. Robert Ross. She has published over 50 scientific papers, reports and chapters related to obesity, health and lifestyle behaviors.
Currently, her laboratory is investigating the relationship between obesity and physical inactivity through clinical human intervention studies and epidemiological approaches. In particular, she is interested in the characterization of the metabolically normal but obese phenotype and is currently working on factors that identify successful weight management in adult and pediatric bariatric patient populations.
Currently, bariatric surgery is the most effective weight loss treatment available. However, it is not without risks. Thus, safer alternatives such as lifestyle and pharmacological interventions should be attempted prior to surgery. The risks for surgical complications are greater with increasing BMI, and preoperative weight loss may decrease the risk for complications beyond what is expected given the patient BMI. This may be due to decreased technically difficulty of surgeries after weight loss due to reduced liver volume and/or decreased visceral fat mass. Further, preoperative weight loss is associated with increased overall weight loss post-surgery in some but not all studies. These differences in weight loss between studies may reflect differences in treatment compliance or the demographics of the studied population. In the diet and physical activity literature, compliance predicts weight loss attainment, when defined by not only sessional attendance, but also adherence to the prescribed protocol. It is unclear whether this is also true with bariatric surgery. Nevertheless, as post-surgical diet and physical activity have been shown to be related with more positive surgical outcomes, one may argue that engaging in proper dietary and physical activity practices prior to surgery is important. Given that this should result in weight loss for the vast majority of patients, and that weight loss is the only readily available objective measure for assessing compliance to the prescribed diet and physical activity program, weight loss should be mandatory before bariatric surgery.
Learning objectives: At the end of this presentation, participants should be able to identify the benefits that patients may expect if they achieve weight loss prior to gastric surgery. Further, they will be able to identify some of the post-operative benefits of maintaining proper dietary and physical activity behaviours. |
