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Weight Loss Surgery More Effective Than Diet

But Risks of Obesity Surgery Are Serious and Real
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WebMD Health News

April 4, 2005 - Weight loss surgeryWeight loss surgery is the most effective way for extremely obese people to lose weight. But this drastic surgery isn't for everybody, a review of obesity treatments shows.

Patients can expect to lose 44 to 67 pounds after weight loss surgery -- and keep it off for up to 10 years, the studies show. Moreover, this weight loss leads to improvements in diabetes and reduced risk of stroke and heart disease, says researcher Melinda A. Maggard MD, of UCLA medical center.

"For patients who are severely obese -- a body mass index [BMI]body mass index [BMI] of 40 or greater -- the surgery is going to produce a very dramatic weight loss for those individuals," Maggard tells WebMD. "But having surgery is not without its risks. That is the other thing this study really highlights. There is a significant morbidity, and a mortality that goes along with the surgery. Even though it is low, if there is a 1% death rate attached to it; it is real."

There is, of course, a catch. Weight loss surgery doesn't work by itself. After any of the various bariatric surgeries,various bariatric surgeries, patients have to go on -- and, for the rest of their lives, stay on --- a strict diet and exercise program.

The first thing that all overweight and obese patients should try is diet and exercise.diet and exercise.

That's because weight loss surgery is not a cosmetic procedure. It's intended to restore health, says surgeon Leena Khaitan, MD, MPH, co-director of the Emory Bariatric Center in Atlanta.

"Weight loss surgery is not done to make patients into supermodels, but to make them healthier," Khaitan tells WebMD. "With exercise and diet alone, often there is a regain of lost weight. Most people are not able to maintain that. But weight loss surgery is not for everybody. It is for the patient who is willing to make the necessary lifestyle change to make the surgery successful. We should not walk up to every obese patient in the world and say, 'You need an operation.'"

The studies -- and obesity treatment guidelines from the American College of Physicians -- appear in the April 5 issue of Annals of Internal Medicine.

A Role for Weight Loss Drugs

Weight loss drugsWeight loss drugs work, too, the studies show. But they have a much more modest effect than surgery -- a weight loss of about 10 pounds after one year of treatment. And the long-term health effects of these drugs is unknown, the studies show.

"The medicines are useful, but they do have a lot of side effects that patients have trouble dealing with," Khaitan says. "And none are approved for long-term use. So when patients stop taking the drugs, they regain weight. So should patients use them? That depends. If a patient has a BMI over 40, if they lose 20 to 30 pounds on a diet and weight loss medications, they will notice some improvement in their health. But they will not be able to achieve the same weight loss as they would with weight loss surgery."

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