Keeping The Weight Off: Which Obesity Treatment Is Most Successful?
obese patients who have lost significant amounts of weight by changing
their diet and exercise habits may be as successful in keeping the
weight off long-term as those individuals who lost weight after
bariatric surgery, according to a new study.
weight loss and maintenance were comparable between the two treatments,
patients who relied on non-surgical methods had to work harder over a
longer duration to maintain their weight losses, said researchers from
The Miriam Hospital's Centers for Behavioral and Preventive Medicine.
findings suggest that its possible to maintain large weight losses
through intensive behavioral efforts, such as changing your approach to
eating and exercise, regardless of whether you lost weight with
bariatric surgery or through non-surgical methods," said lead author
Dale Bond, PhD, of The Miriam Hospital's Centers for Behavioral and
Preventive Medicine. "Behavioral modifications and lifestyle changes
are critical components to long-term weight loss maintenance."
matched each surgical patient with two non-surgical patients through
the National Weight Control Registry. All participants – 315
total – lost an average of 124 lbs and had maintained their
weight loss for an average of 5.5 years at the beginning of this
were surveyed at both the start of the study and at the one-year
follow-up about weight-maintenance behaviors (including food records
and physical activity levels) and various psychological factors (such
as dietary restraint, feelings of hunger and food cravings, stress and
depression). Weight-related information was collected at both the one-
and two-year follow-up.
were no significant differences in the caloric intake or the amount of
weight regain between the surgical and non-surgical groups; both
regained an average of about four lbs. each year. However, researchers
identified behavioral differences between the two groups, with
bariatric patients reporting greater fat and fast food consumption,
less conscious control over their eating and higher incidences of
depression and more stress than non-surgical patients.
differences were observed with physical activity behaviors. Only
one-third of the surgical group reported engaging in a level of
physical activity consistent with recommendations for preventing weight
regain compared with 60 percent of the non-surgical group.
researchers note that susceptibility to cues that trigger impulsive
overeating was the only behavior associated with a greater risk of
weight regain in both groups.
findings underscore the need for eating and activity interventions
focused on bariatric surgery patients," said Bond, who is also a
research fellow in psychiatry (weight control) at the Warren Alpert
Medical School of Brown University. "Future research should focus on
ways to increase and maintain physical activity and better monitor
psychological parameters in bariatric surgery patients to facilitate
optimal long-term weight control."
study was supported by a grant from the National Institutes of Health
and was publishedonline by the International Journal of Obesity.