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People say you can lose it on your own

Patients often tell me they hear, “just diet and exercise and you can lose the weight on your own, without surgery.”  This refrain is common from concerned family members and friends.  While this advice is often rooted in love, it ignores the reality of the situation.

People who benefit from weight loss surgery are 100 pounds or more overweight.  The typical patient I see weighs over 250 pounds and averages 150 pounds over an ideal body weight.  If a person is only 30 – 50 pounds overweight, she can diet for a month or two and lose 10 – 20 pounds fairly quickly.  She would be close to a healthy weight and could then just maintain, without needing additional dietary restriction.  However, a person of average height who weighs over 250 pounds would still have a long way to go to get close to a healthy weight.  In fact, it usually takes 18 months to achieve a nadir weight after bariatric surgery.  It is extremely difficult for anyone to diet and starve himself for that long of a period of time without some help to take away the hunger pains and the feeling of deprivation.  Studies show that only 1% of morbidly obese people can achieve meaningful, long-term weight loss without surgery.

One landmark study validating the shortcomings of non-surgical weight loss is the Swedish Obesity Study.  You can find the original abstract for this study on our website here.  This study compared two groups of morbidly obese people, each group having just over 600 participants.  The first group had bariatric surgery while the second group of people kept trying to diet and exercise alone under a doctor’s supervision.  The investigators checked back on the two groups 10 years later.  What do you think they found?

– The weight loss surgery group maintained a 25% weight loss ten years later;

– The non-surgical group had gained an additional 1.6% of their starting weight ten years later.

This study confirms what countless other studies have found as well.  It also fits with our everyday experience.  How many people do you know who have been able to lose 50-100 pounds and keep it off for 10 years?  I know bariatric surgery is not the perfect solution to the obesity epidemic.  That would be prevention.  But it is a lot better than the alternative, which all too often just doesn’t work.

Carl Lowe, Jr., MD

Discussion

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