{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:28:01Z","timestamp":1786350481983,"version":"build-2736575974"},"reference-count":50,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Importance: Multimodal prehabilitation improves outcomes in colorectal surgery, but its effectiveness and cost-effectiveness before metabolic and bariatric surgery are unknown.\nObjective: To evaluate the effectiveness and cost-effectiveness of a 6-week multimodal prehabilitation programme compared with standard preintervention education in patients undergoing bariatric surgery.\nDesign, setting, and participants: Propensity score matched cohort observational study at Shanghai Tenth People\u2019s Hospital, China, January 2022 to January 2025. Sixty prehabilitation patients were matched 1:1 to 60 controls from 254 standard care candidates using nearest-neighbour matching on the logit of the propensity score. Follow-up was 12 months.\nInterventions: A 6-week programme of supervised exercise, nutritional counselling, and psychological support vs 2 standard preoperative counselling sessions. All patients underwent Roux-en-Y gastric bypass or sleeve gastrectomy.\nMain outcomes and measures: Total weight loss at 12 months. Secondary outcomes included body composition, metabolic parameters, functional capacity, patient-reported outcomes, safety, and healthcare costs.\nResults: Among 120 matched patients (mean [SD] age, 32.6 [5.2] years; 65.8% male; mean body mass index [BMI], 38.2 [3.2] kg\/m2), total weight loss at 12 months did not differ between groups (23.7 [5.1] vs 23.4 [2.7] kg; difference, 0.3 kg; 95% CI, \u22121.3 to 1.8; p\u2009=\u20090.75). At 3 months, prehabilitation showed significantly greater weight loss (adjusted \u03b2\u2009=\u20092.85 kg; 95% CI, 1.77 to 3.93; p\u2009&lt;\u20090.001), lower body fat, lower diastolic blood pressure, and higher Short Form-36 (SF-36) mental scores. All differences were attenuated by 6 months. No serious adverse events occurred. Total costs were modestly higher in the prehabilitation group (mean, \u00a584 843 vs \u00a578 051), a difference attributable almost entirely to the prehabilitation programme itself; because the incremental effect on weight loss at 12 months was not statistically significant, a meaningful incremental cost-effectiveness ratio could not be estimated.\nConclusions and relevance: A 6-week multimodal prehabilitation programme accelerated early postoperative weight loss and improved short-term functional outcomes but did not improve total weight loss at 12 months. Because prehabilitation added cost without a demonstrable difference in 12-month weight loss, a cost-effectiveness advantage could not be established. The dominant metabolic effects of bariatric surgery appear to override the incremental gains of preoperative conditioning over time.<\/jats:p>","DOI":"10.2340\/jrm.v58.45736","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:31:59Z","timestamp":1786347119000},"page":"jrm45736","source":"Crossref","is-referenced-by-count":0,"title":["Prehabilitation for patients undergoing metabolic\/bariatric surgery: a retrospective cohort study using propensity score matching"],"prefix":"10.2340","volume":"58","author":[{"given":"Yiling","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengdi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heming","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayuan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"165103","unstructured":"NCD Risk Factor Collaboration (NCD-RisC). 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Effect of multimodal prehabilitation vs postoperative rehabilitation on 30-day postoperative complications for frail patients undergoing resection of colorectal cancer: a randomized clinical trial. JAMA Surg 2020; 155: 233\u2013242.","DOI":"10.1001\/jamasurg.2019.5474"},{"key":"165114","doi-asserted-by":"crossref","unstructured":"Molenaar CJL, Minnella EM, Coca-Martinez M, ten Cate DWG, Regis M, Awasthi R, et al. Effect of multimodal prehabilitation on reducing postoperative complications and enhancing functional capacity following colorectal cancer surgery: the PREHAB randomized clinical trial. JAMA Surg 2023; 158: 572\u2013581.","DOI":"10.1001\/jamasurg.2023.0198"},{"key":"165115","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Delgado Y, L\u00f3pez-Madrazo-Hern\u00e1ndez MJ, Alvarado-Martel D, Miranda-Calder\u00edn G, Ugarte-Lopetegui A, Gonz\u00e1lez-Medina RA, et al. Prehabilitation for bariatric surgery: a randomized, controlled trial protocol and pilot study. 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