You are here

Article Text

Article menu
Download PDFPDF
Therapeutics
Review: sparse high quality evidence supports surgery for obesity

https://doi.org/10.1136/ebm.10.5.141

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547–59.
    OpenUrlCrossRefPubMedWeb of Science

    
 
 Q How effective and safe are surgical treatments for obesity?

    METHODS

    Embedded ImageData sources:

    Medline and EMBASE/Excerpta Medica (to July 2003), and existing systematic reviews.

    Embedded ImageStudy selection and assessment:

    randomised controlled trials (RCTs), controlled clinical trials, cohort studies, and case series that evaluated surgical treatment of obesity.

    Embedded ImageOutcomes:

    weight loss, mortality, complication rates, and control of major obesity related comorbid conditions.

    MAIN RESULTS

    147 studies met the inclusion criteria: 89 reported weight loss results (mean age 38 y, 75% women, baseline body mass index 47 kg/m2), 134 reported mortality rates, and 128 reported complications rates. The analysis focused on the most common currently performed surgical procedures: Roux-en-Y gastric bypass (RYGB) (including open and laparoscopic), vertical banded gastroplasty (VBG), adjustable gastric banding, and biliopancreatic diversion (including duodenal switch).

    Weight loss. 3 RCTs compared surgery with no surgery. 2 older RCTs favoured surgery: 1 RCT from 1984 showed greater weight loss at 24 months with horizontal gastroplasty plus diet than with diet alone (31 v 8 kg); 1 RCT from 1979 comparing jejunoileal bypass with medical treatment showed a 37 kg difference favouring surgery at 24 months. 1 RCT available only in abstract form that compared surgery with medical therapy (very low calorie diet, pharmacotherapy, and …

    View Full Text

    Footnotes

    • For correspondence: Dr M A Maggard, University of California, Los Angeles, Los Angeles, CA, USA. mmaggardmednet.ucla.edu

    • Source of funding: Agency for Healthcare Research and Quality.