Skip to main content
Log in

Bariatric Surgery versus Lifestyle Interventions for Morbid Obesity—Changes in Body Weight, Risk Factors and Comorbidities at 1 Year

  • Clinical Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. World Health Organization. Obesity and overweight—fact sheet N° 311. 2006.

  2. Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282(16):1523–9.

    Article  PubMed  CAS  Google Scholar 

  3. Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341(15):1097–105.

    Article  PubMed  CAS  Google Scholar 

  4. IOTF and EASO. Obesity in Europe—the case for action. 2002.

  5. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res. 1995;3 Suppl 2:211s–6.

    PubMed  Google Scholar 

  6. Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology. 2007;132:2226–38.

    Article  PubMed  Google Scholar 

  7. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  8. Strømmen M, Kulseng B, Vedul-Kjelsås E, et al. Bariatric surgery or lifestyle intervention? An exploratory study of severely obese patients’ motivation for two different treatments. Obes Res Clin Pract. 2009;3:193–201.

    Article  Google Scholar 

  9. Elder KA, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007;132:2253–71.

    Article  PubMed  Google Scholar 

  10. Anderson JW, Grant L, Gotthelf L, et al. Weight loss and long-term follow-up of severely obese individuals treated with an intense behavioral program. Int J Obes. 2007;31(3):488–93.

    Article  CAS  Google Scholar 

  11. Anderson JW, Conley SB, Nicholas AS. One hundred pound weight losses with an intensive behavioral program: changes in risk factors in 118 patients with long-term follow-up. Am J Clin Nutr. 2007;86(2):301–7.

    PubMed  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 

  13. Christiansen T, Brunn JM, Madsen EL, et al. Weight loss maintenance in severely obese adults after an intensive lifestyle intervention: 2- to 4-year follow-up. Obesity. 2007;15(2):413–20.

    Article  PubMed  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.

    CAS  Google Scholar 

  16. Shapiro JR, Stout AL, Musante GJ. “Structure-size me”: weight and health changes in a four week residential program. Eat Behav. 2006;7(3):229–34.

    Article  PubMed  Google Scholar 

  17. Maffiulettil NA, Agosti F, Marinone PG, et al. Changes in body composition, physical performance and cardiovascular risk factors after a 3-week integrated body weight reduction program and after 1-y follow-up in severely obese men and women. Eur J Clin Nutr. 2005;59:685–94.

    Article  Google Scholar 

  18. Sjostrom M, Karlsson AB, Kaati G, et al. A four week residential program for primary health care patients to control obesity and related heart risk factors: effective application of principles of learning and lifestyle change. Eur J Clin Nutr. 1999;53 Suppl 2:S72–7.

    Article  PubMed  Google Scholar 

  19. Perri MG, Nezu AM, Patti ET, et al. Effect of length of treatment on weight loss. J Consult Clin Psychol. 1989;57(3):450–2.

    Article  PubMed  CAS  Google Scholar 

  20. Latner JD, Stunkard AJ, Wilson GT, et al. Effective long-term treatment of obesity: a continuing care model. Int J Obes Relat Metab Disord. 2000;24(7):893–8.

    Article  PubMed  CAS  Google Scholar 

  21. Dalle Grave R, Melchionda N, Calugi S, et al. Continuous care in the treatment of obesity: an observational multicentre study. J Intern Med. 2005;258(3):265–73.

    Article  PubMed  CAS  Google Scholar 

  22. Dale KS, McAuley KA, Taylor RW, et al. Determining optimal approaches for weight maintenance: a randomized controlled trial. CMAJ. 2009;180(10):E39–46.

    Article  PubMed  Google Scholar 

  23. Scotland SC, Larocque M. Early treatment response as a predictor of ongoing weight loss in obesity treatment. Br J Health Psychol. 2005;10(Pt 4):601–14.

    Article  Google Scholar 

  24. Elfhag K, Rossner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev. 2005;6(1):67–85.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank the nursing staff of the Centre for Obesity, Department of Surgery at St. Olav University Hospital, in particular Mrs. Sissel Salater and Mrs. Randi Pierre for their technical and clinical assistance, and all the research participants for their cooperation and commitment.

Funding and conflict of interest

This project was supported by a grant from Central Norway Regional Health Authority. The authors declare that there is no conflict of interest that would prejudice the impartiality of this scientific work.

Disclosure statement

The authors have nothing to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Catia Martins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Martins, C., Strømmen, M., Stavne, O.A. et al. Bariatric Surgery versus Lifestyle Interventions for Morbid Obesity—Changes in Body Weight, Risk Factors and Comorbidities at 1 Year. OBES SURG 21, 841–849 (2011). https://doi.org/10.1007/s11695-010-0131-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-010-0131-1

Keywords

Navigation