• Alexis M Holland, William R Lorenz, Sullivan A Ayuso, Michael M Katzen, Souma Kundu, David A Rosas, Brittany S Mead, Gregory T Scarola, Vedra A Augenstein, and B Todd Heniford.
• Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC.
• J. Am. Coll. Surg. 2025 Feb 5.

BackgroundObesity is directly correlated with wound complications and recurrence following open ventral hernia repair (OVHR). Preoperative weight loss (WL) mitigates these risks, improves overall health, and reduces intraabdominal volume. For patients successful in losing weight, it is unclear whether this WL is maintained.Study DesignA prospective, single-institution hernia database was queried for patients with a BMI≥25kg/m2, who were requested to lose weight and lost a minimum of 10lbs preoperatively. Patients' weight was examined at two timepoints: postoperative appointment 6months-1year and their most recent documented weight.ResultsOf 256 included patients, average age was 58.2±11.2 years, 30.5% were diabetic, and 67.9% were ASA class III-IV. At initial consultation, average BMI was 38.2±6.6kg/m2 and 34.0±5.8kg/m2 at time of surgery. Average preoperative WL was 26.1±17.1lbs (10-120lbs) over 10.0±13.6 months.At the first postoperative timepoint, average BMI was 33.6±5.8kg/m2, and patients lost an additional 1.8±16.2lbs over 8.4±9.0 months after surgery. At 42.0±36.2 months postoperatively, patients gained an average of 2.0±27.1lbs, for a net WL of 24.0±31.9lbs from consultation.After surgery, 47.3% of patients continued WL for an additional 18.6±26.4lbs (total net WL: 44.7lbs) and decreased BMI by 2.5±3.6kg/m2; 0.8% maintained their same weight; 22.3% gained back less than half of preoperative WL, totaling 70.3% of patients with long-term optimization.ConclusionPrehabilitation-induced WL averaged 26lbs. With 3.5years follow-up, patients weighed an average of 24lbs less than their initial consult weight. Nearly half of patients continued WL postoperatively, and more than 70% maintained at least half of their WL, demonstrating longevity to preoperative optimization.Copyright © 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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