Is surgery better than dieting for weight loss outcomes?

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There are many different ways to manage weight, but which is better for our long-term health? A new study has found a link between multip
le types of weight loss surgery and lower all-cause mortality rates overall.

doctors performing surgery

New research has uncovered an association between bariatric surgery and lower death rates.

According to data from the Centers for Disease Control and Prevention (CDC), over a third of adults in the United States lives with obesity.

This is particularly worrisome as the condition is also linked to other negative health outcomes, including diabetes, heart disease, and certain types of cancer.

The most common ways to manage excess weight are dieting, physical exercise, weight loss drugs, and bariatric, or weight loss, surgery.

Individuals aiming to get back into shape may opt for one or a combination of these treatments, depending on what choices are most suitable for them.

Bariatric surgery is usually offered to individuals diagnosed with “severe obesity,” which is defined as a having a body mass index (BMI) of over 35.

This surgery type aims to make the stomach smaller, so that a person’s appetite — as well as the amount of food that they can ingest — is reduced.

Types of bariatric surgery include:

  • laparoscopic banding, during which a ring is placed around a segment of the stomach so as to “section off” part of it, thereby reducing how much of the stomach a person can use to ingest food
  • gastric bypass, or Roux-en-Y gastric bypass, which requires both “sectioning off” the stomach so that less food can be ingested, and cutting the low intestine so that it can be attached directly to the now-smaller section of the stomach
  • laparoscopic sleeve gastrectomy, in which much of the stomach is removed, with only a smaller “wedge” left, which can hold a lower amount of food

Recently, Orna Reges, Ph.D., and others from Clalit Health Services in Tel Aviv, Israel, conducted a study that explored which types of weight loss strategy and procedures are associated with a lower risk of all-cause mortality.

The findings of their study are published in the Journal of the American Medical Association.

Surgery versus nonsurgical management

Reges and her team conducted a retrospective cohort study that involved 8,385 people diagnosed with obesity, all of whom had had some type of weight loss surgery (either laparoscopic banding, gastric bypass, or gastrectomy) between 2005 and 2014, and 25,155 people who followed alternative obesity management programs, as advised by their physicians.

Obesity management interventions included counseling sessions that targeted diet and working to improve eating behaviors. The participants in the two groups were matched as closely as possible for age — with a median age of 46 — and biological sex.

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