Obesity is a major, growing health problem.
Observational studies suggest that bariatric surgery is more effective than nonsurgical therapy, but no randomized, controlled trials have confirmed this.
Dr Paul O'Brien and colleagues from Australia conducted a randomized controlled trial comparing surgical therapy with non-surgical therapy.
The research team ascertained whether surgical therapy for obesity achieves better weight loss, health, and quality of life than nonsurgical therapy.
The interventions were conducted in University departments of medicine and surgery and an affiliated private hospital.
The team recruited 80 adults from the community with mild to moderate obesity, a body mass index of 30 kg/m2 to 35 kg/m2.
Patients were assigned to a program of very-low-calorie diets, pharmacotherapy, and lifestyle change for 24 months in the non-surgical group.
|87% of excess weight was lost with surgery vs 22% with non-surgical interventions|
|Annals of Internal Medicine|
The surgical group of patients were assigned to placement of a laparoscopic adjustable gastric band.
Outcome measures were weight change, presence of the metabolic syndrome, and change in quality of life at 2 years.
At 2 years, the team found that the surgical group had greater weight loss, with a mean of 22% of initial weight and 87% of excess weight lost.
The researchers observed that the non-surgical group had a loss of 6% of initial weight, and 22% of excess weight.
The metabolic syndrome was initially present in 38% of patients in each group.
The team noted that the metabolic syndrome was present in 24% of non-surgical patients and 3% of surgical patient at the completion of the study.
Quality of life improved statistically significantly more in the surgical group than in the nonsurgical group.
The team reported that the was not powered for comparison of adverse events, and examined outcomes only for 24 months.
Dr O'Brien's team commented, “Surgical treatment using laparoscopic adjustable gastric banding was statistically significantly more effective than nonsurgical therapy in reducing weight.”
“It is also more effective in resolving the metabolic syndrome, and improving quality of life during a 24-month treatment program.”