Introduction In preparation for bariatric surgery, patients undergo nutritional counseling and are recommended to follow strict dietary instructions for weight loss. Significant weight loss reduces liver volume, reduces perioperative complications, and sets the foundation for long-term surgical success. Research suggests that educating patients about various food choices and integrating exercise routines into their daily lives can further enhance surgical outcomes and promote healthier long-term decision making.

Traditionally, nutritional counseling for bariatric surgery patients was given through one-on-one in-person sessions. However, during the COVID-19 pandemic, most of these sessions were conducted virtually. Despite the growing prevalence of virtual sessions, there has been limited research on their effectiveness in comparison to in-person sessions. This study analyzes the efficacy of preoperative nutritional counseling by comparing in-person sessions to virtual sessions.

Methods A retrospective chart review of 365 patients who underwent bariatric weight loss surgery at Carle Foundation Hospital from 2018-2023 was conducted. Based on the method of pre-operative diet counseling, two groups were identified: patients who received virtual counseling and those who received in-person counseling. Data was collected on weight and BMI changes between the initial nutrition consultation date and the surgery date. Significance was calculated using the independent t-test and Spearman's correlation coefficient.

Results Of the cohort of 365 patients, 80.8% (295) of patients received in-person counseling while 19.2% (70) of patients received virtual counseling. 81.4% (297) of patients were female. The in-person group demonstrated greater average weight losses compared to the virtual group (7.46 kg vs. 0.51 kg, p = 0.011). Similarly, the in-person group had a greater mean BMI change (-2.60 kg/m² vs. -0.39 kg/m², p = 0.019). The average minutes spent in the first nutrition consultation for the in-person and virtual groups was 48.0 minutes and 41.1 minutes respectively. While there was no correlation between time spent during consultation and weight loss for the in-person group (r = 0.064, p > 0.05), there is a positive correlation for the virtual group (r = 0.415, p < 0.001).

Conclusion Our results suggest that in-person education is more effective for weight loss and BMI reduction. There is a positive correlation between time spent in the first pre-operative nutrition consult and weight loss for virtual patients.