Bariatric Surgery Versus Lifestyle Intervention in Class I Obesity: 7-10-Year Results of a Retrospective Study

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2018 Nov 16

PMID 30430189

Citations 11

Authors

Antonio Vitiello

Luigi Angrisani

Antonella Santonicola

Paola Iovino

Vincenzo Pilone

Pietro Forestieri

Affiliations

Soon will be listed here.

Abstract

Introduction: The American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation of Surgery for Obesity (IFSO) have both stated that bariatric surgery (BS) should not be denied in Class I patients. However, lifestyle intervention (LI), such as diet plus gym programs, is still considered the preferred approach for subjects with a BMI ranging from 30 to 35 kg/m. The aim of this study was to retrospectively compare results of LI and BS in patients in Class I obesity.

Methods: Retrospective analysis of prospective maintained databases of two centers for the "Interdisciplinary Treatment of Obesity" was performed. All patients in Class I obesity and follow-up >7 years were included in the study. Subjects were divided into two groups: BS group that included patients who had undergone surgery and LI group that included patients who underwent lifestyle intervention (LI). Percentage of excess body mass index loss (%EBMIL) and comorbidities remission were recorded.

Results: Seventy-six patients were included in the study. Fifty-six subjects were submitted to surgery (BS group); 20 subjects were treated with nonsurgical approach (LI group). In BS group, 34 underwent laparoscopic adjustable gastric band, 13 laparoscopic sleeve gastrectomy (LSG), and 9 laparoscopic Roux-en-Y gastric bypass. EWL% resulted significantly higher in BS group at 1, 3, 5, 7 and 10 years (p < 0.01).

Conclusion: Bariatric surgery is more effective than LI for patients in Class I obesity. Due to its versatility, low-risk profile and high-effectiveness LSG could be the standard intervention for these patients.

Citing Articles

Scientific Evidence for the Updated Guidelines on Indications for Metabolic and Bariatric Surgery (IFSO/ASMBS).

De Luca M, Shikora S, Eisenberg D, Angrisani L, Parmar C, Alqahtani A Obes Surg. 2024; 34(11):3963-4096.

PMID: 39320627 PMC: 11541402. DOI: 10.1007/s11695-024-07370-7.

Safety and efficacy of sleeve gastrectomy in non-diabetic individuals with class I vs. class II obesity: a matched controlled experiment from Tehran Obesity Treatment Study (TOTS).

Heidari Almasi M, Barzin M, Khalaj A, Mahdavi M, Valizadeh M, Hosseinpanah F Surg Endosc. 2024; 38(11):6625-6636.

PMID: 39289225 DOI: 10.1007/s00464-024-11240-9.

Midterm outcomes of one anastomosis gastric bypass for patients with BMI < 35 kg/m from a large single center.

Shahmiri S, Safari S, Sheikhbahaei E, Fathi M, Moosavi D, Daryabari S Surg Endosc. 2024; 38(7):3940-3947.

PMID: 38844728 DOI: 10.1007/s00464-024-10928-2.

One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass: A Randomized Prospective Trial.

Karagul S, Senol S, Karakose O, Uzunoglu K, Kayaalp C Medicina (Kaunas). 2024; 60(2).

PMID: 38399543 PMC: 10890302. DOI: 10.3390/medicina60020256.

Single anastomosis duodeno-ileal bypass with sleeve gastrectomy generates sustained improvement of glycemic control compared with sleeve gastrectomy in the diet-induced obese rat model.

Becerril S, Cienfuegos J, Rodriguez A, Catalan V, Ramirez B, Valenti V J Physiol Biochem. 2023; 80(1):149-160.

PMID: 37935948 PMC: 10810039. DOI: 10.1007/s13105-023-00993-x.

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