For some obese people, surgery beats other options

Diet, exercise, therapy and drugs can help obese people get healthier. But weight-loss surgery does a better job of getting rid of extra pounds and treating type 2 diabetes, a new review of past studies shows.

The studies only followed people for two years. So it's possible the results would look different further down the line, the authors write.

So-called bariatric surgery, like gastric bypass or gastric banding, reduces the size of the stomach so patients can only eat small amounts of food.

Many doctors have noted the dramatic weight loss that often results. But it wasn't obvious how surgery stacks up against traditional diet and exercise strategies.

The new review included 11 studies. Each study randomly chose some obese people to have surgery and others to make diet or lifestyle changes instead, for instance. Together those studies included close to 800 people.

Participants in the bariatric surgery groups lost an average of 57 more pounds than those in the non-surgery groups. Average weight loss ranged from 45 to 100 pounds among those who had surgery.

More people who had type 2 diabetes saw their blood sugar levels fall into the normal range after surgery than after a different intervention.

"Although they try to look at a range of medical conditions, in reality the real importance is the effect of weight loss on diabetes and the relative effectiveness of non-surgical versus surgical approaches," said Dr. Paul O'Brien.

O'Brien is an obesity specialist who pioneered the Lap-Band procedure in Australia in 1994. He founded the Centre for Obesity Research and Education at Monash University in Melbourne and was not involved in the new review.

"The clear and consistent message is the bariatric surgical procedures achieve a much better outcome," O'Brien said.

Bariatric surgery will certainly help obese people with diabetes better control the disease and may put it into remission entirely, he said.

"Given that there are probably in excess of 300 million people across the world with type 2 diabetes and maybe half of these are obese, this opens up huge possibilities for better health," O'Brien told Reuters Health.

But two years isn't really enough time to judge the results. And the analysis included small numbers of studies and patients, Viktoria L. Gloy from University Hospital Basel in Switzerland and colleagues note in the journal BMJ.

Longer-term studies, cost-effectiveness studies and comparisons between different surgeries are still missing, O'Brien said.

The authors did not respond to a request for comment before deadline.

Surgery is typically recommended for people with a body mass index - a measure of weight in relation to height - of at least 40, or at least 35 if they also have co-occurring health problems such as diabetes or severe sleep apnea.