Bariatric Surgery versus Lifestyle Interventions for Morbid Obesity—Changes in Body Weight, Risk Factors and Comorbidities at 1 Year
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Few studies have looked at non-surgical alternatives for morbid obese patients. This study aims to compare 1-year weight loss and changes in risk factors and comorbidities after bariatric surgery and three conservative treatments.
Patients with morbid obesity (BMI > 40 or BMI > 35 kg/m2 plus comorbidities) on waiting list for bariatric surgery, were non-randomly allocated to (A) bariatric surgery or to one of three conservative treatments; (B) residential intermittent program; (C) commercial weight loss camp and (D) hospital outpatient program. Body weight, risk factors and comorbidities were assessed at baseline and 1 year.
Of 206 participants, 179 completed the study. All treatments resulted in significant weight loss, but bariatric surgery (40 ± 14 kg, 31 ± 9%) led to the largest weight loss (P < 0.0001). There were no differences in weight loss between B and C (22 ± 13 kg, 15 ± 8% vs. 18 ± 12 kg, 13 ± 8%), but these resulted in larger weight loss compared with D (7 ± 10 kg, 5 ± 8%). There were no differences in changes in total or LDL cholesterol, triacylglycerols or glucose between groups; however, the increase in HDL cholesterol was significantly larger in groups A and C. There were no differences in comorbidities resolution between groups A and B, C and D combined (except hypertension, which was better in group A).
In conclusion, although bariatric surgery leads to a greater weight loss at 1 year compared with conservative treatment, in patients with morbid obesity, clinical significant weight loss and similar improvements in risk factors and comorbidities resolution can also be achieved with lifestyle interventions.
KeywordsObesity Weight loss Lifestyle modifications Obesity surgery
- 1.World Health Organization. Obesity and overweight—fact sheet N° 311. 2006.Google Scholar
- 4.IOTF and EASO. Obesity in Europe—the case for action. 2002.Google Scholar
- 12.Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(499):502.Google Scholar
- 14.Ryan D, Johnson W, Myers V, et al. Non-surgical weight loss for extreme obesity: results of the Louisiana Obese Subjects Study (LOSS). Obesity Facts. 2009;2(Supl. 2):23.Google Scholar
- 15.Bjorvell H, Rossner S. A ten-year follow-up of weight change in severely obese subjects treated in a combined behavioural modification programme. Int J Obes. 1992;16:623–5.Google Scholar