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Bariatric surgery versus non-surgical treatment for obesity

This week's publication of the British Medical Journal compares bariatric surgery with non-surgical treatment for obesity.

News image

Dr Viktoria Gloy and colleagues quantified the overall effects of bariatric surgery compared with non-surgical treatment for obesity.

The team performed a systematic review and meta-analysis based on a random effects model.

The team searched Medline, Embase, and the Cochrane Library from their inception to 2012 regardless of language or publication status.

Eligible studies were randomized controlled trials with 6 months or more of follow-up that included individuals with a body mass index of 30 or more, compared current bariatric surgery techniques with non-surgical treatment.

Studies reported on body weight, cardiovascular risk factors, quality of life, or adverse events.

Individuals allocated to bariatric surgery had a higher remission rate of type 2 diabetes
British Medical Journal

The meta-analysis included 11 studies with 796 individuals.

Individuals allocated to bariatric surgery lost more body weight compared with non-surgical treatment, had a higher remission rate of type 2 diabetes, and metabolic syndrome, greater improvements in quality of life and reductions in medicine use.

Plasma triglyceride concentrations decreased more, and high density lipoprotein cholesterol concentrations increased more.

The research team found that changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different.

The team observed no cardiovascular events or deaths reported after bariatric surgery.

The most common adverse events after bariatric surgery were iron deficiency anemia, and reoperations.

Dr Gloy's team concludes, "Compared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss, and higher remission rates of type 2 diabetes and metabolic syndrome."

"However, results are limited to two years of follow-up and based on a small number of studies and individuals."

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5934
06 November 2013

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