Research Highlights: Compilation of Studies Suggests that Bariatric Surgeries May Be More Effective at Treating Obesity than Non-Surgical Treatment Options

Compilation of Studies Suggests that Bariatric Surgeries May Be More Effective at Treating Obesity than Non-Surgical Treatment Options

A recent article published in the British Medical Journal indicated that bariatric surgeries to treat obesity may be more effective than non-surgical obesity treatments. Bariatric surgery is defined as a surgery that reduces the size of the stomach to promote patient weight loss. Non-surgical treatments include diet changes, increased exercise, pharmacotherapy, and general lifestyle alterations. The results of this research were based on a series of different randomized studies conducted on patients with a body mass index of 30 or greater. The patients received either a bariatric surgery or a non-surgical therapy to treat their obesity and investigators recorded body weight, waist circumference, blood pressure, glucose levels, and several other criteria to determine the relative effectiveness of either treatment.
In all studies, patients undergoing bariatric surgery lost more weight than patients treated with non-surgical options with the mean weight loss difference between the two treatments being 26 kilograms. The circumference of patients’ waists also decreased far more when patients had received bariatric surgery, with a mean waist circumference difference of 16 centimeters between the two treatment options. There was no statistically significant difference between changes in blood pressure or changes in total cholesterol levels for either treatment option. However, patients undergoing bariatric surgeries also showed a greater overall decrease in triglyceride and glucose levels, as well as higher remission rates for type 2 diabetes and metabolic syndrome in some studies. 
There is some uncertainty in these results as investigators only looked at 11 different studies to compile this research and these studies were relatively small with up to only a 2-year follow-up. Investigators consider these factors to be limitations for this research. Furthermore, each study was conducted under different conditions. Five studies focused specifically on patients with type 2 diabetes, three studies contained only patients who had previously tried to lose weight, and one study only focused on patients with obstructive sleep apnea. However, investigators claim that the variety of study conditions is a strong point of this research since it shows that bariatric surgery was consistently more effective than non-surgical treatments, even across a wide range of subgroups and study conditions. This research can thus be considered a comprehensive comparison of bariatric surgery and non-surgical treatments, though more studies must be conducted in order to further prove the greater effectiveness of bariatric surgery.
BMJ. 2013. 347: f5934.


Caroline Russell-Troutman is the 2013-2014 Research Highlights Editor.