Fitness levels—pre-and post-surgical—may have significant impact on outcomes following obesity surgery, according to a recent study published in the August issue of Chest. Researchers suggest that patients planning on having obesity surgery should be at a certain level of fitness before the operation. Currently, no standard has been set to assess a surgical candidate's potential for complications, but lead author Peter A. McCullough, MD, MPH, of William Beaumont Hospital in Michigan believes that fitness levels should be a consideration. Dr. McCullough and his team followed 109 patients preparing for Rouxen- Y gastric bypass surgery. Their fitness levels were determined by treadmill tests before surgery to show how well the heart, lungs, and blood vessels would perform under stress. Among those patients who exhibited poor levels of fitness, almost 17% suffered serious shortterm complications from the surgery, including kidney failure or blood clots; one patient had a stroke and another died. Of the patients who were deemed the most fit, less than 3% experienced complications and none of them died. Dr. McCullough feels that fitness tests could change the way obesity surgery is approached. Once a fitness test indicates a potentially high-risk patient, the physician can prescribe an exercise and weight-loss plan that could get the patient through the surgery. While many obese patients have poor levels of fitness, according to Dr. McCullough, many patients who have only mild impairments could realize a difference with activities such as walking.

Ms. Farley is a freelance medical writer based in Wakefield, RI.