If you are considering bariatric weight-loss surgery, the October issue of the Archives of Surgery includes some practical advice and a sobering finding.

Here’s the advice. Don’t wait until you have the surgery to start losing weight.

A study of 884 high-risk, morbidly obese patients found those who lost 5 to 10 percent of their excess weight before surgery had a better result than similar patients who did not. The report is from investigators at Geisinger Health System, in Danville, Pa.

They found patients who lost 5 to 10 percent of their weight before surgery left the hospital faster and were twice as likely as other patients to lose 70 percent of their extra weight within the year.

The study focused on older patients with medical problems, like diabetes, liver inflammation and circulatory problems, that push them into the high-risk category.

Earlier studies have suggested that even limited weight loss helps ease chronic health problems. But the study’s authors said additional research is needed to understand how losing weight before surgery could help individuals shed pounds later.

Here is something else to think about. Weight-loss surgery patients had higher death rates, including rates of suicide, than the general population. That’s the conclusion of a University of Pittsburgh analysis of 16,683 bariatric surgeries performed in Pennsylvania between 1994 and 2005.

The surgery patients were “substantially” more likely to die within five years of surgery than were other Pennsylvania residents who were the same age and sex. About 1 percent of surgery patients died within a year of the procedure. More than 6 percent were dead within five years, the authors noted.

The findings prompted researchers to recommend surgery patient receive better follow-up and support.