Bariatric surgery versus lifestyle interventions for morbid obesity--changes in body weight, risk factors and comorbidities at 1 year.
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/m(2) 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).


CONCLUSIONS
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.
Martins
Catia
C
Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. catia.martins@ntnu.no
Strømmen
Magnus
M
Stavne
Ola A
OA
Nossum
Randi
R
Mårvik
Ronald
R
Kulseng
Bård
B
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000628:therapy*; D011615:Psychotherapy, Group; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
D001786:Blood Glucose; D008055:Lipids