Operation yields best results for severe obesity

Surgical treatment of severe obesity provides long-term wait loss and better quality of life compared with conventional treatment in primary health care. This is shown in a ten-year follow-up of the psychosocial component of the Swedish Obese Subjects project, SOS, at the Sahlgrenska University Hospital in Gothenburg.

Thus far the follow-up comprises 1 276 subjects with severe obesity. Of these, 655 had been treated surgically and 621 had undergone treatment in primary care, following routines that usually include some form of dietary and exercise counseling.

“On average those who were operated on had lost about 28 kilograms (that is, about 25 percent) by the one-year check-up. After ten years the average weight loss was 16 percent in the group that had been treated surgically,” says Marianne Sullivan, who is directing the project about health-related quality of life and obesity treatment at the Section for Care Research, Sahlgrenska University Hospital.

“Despite a certain amount of regained weight after ten years, we can establish that only surgical intervention in cases of severe obesity provides long-lasting weight-loss results and therefore enhanced quality of life. In the conventionally treated group neither weight nor quality of life had changed after one year, and after ten years there was a 1.6 percent gain in weight.”

Among subjects who were operated on there was a dramatic increase in quality of life­-the more weight loss, the better­-and those who sustained a weight reduction of about 25 percent after ten years have achieved the same general sense of good health, emotional well-being, and psychosocial functionality as the population in general.

“The positive results span the whole spectrum of so-called health-related quality of life. This includes both obesity-related psychosocial problems, such as bathing in public, participating in organizations, trying on and purchasing clothing, and eating behavior, including fewer hunger pangs, and improved general perceptions of health and physical functions. There was also considerable improvement in mental well-being, with less anxiety, poor self-esteem, etc.”

The study also indicates that the advantages of the treatment are equally great for men and women. This is true not only of quality of life issues but also a number of benefits like decreased risk of diabetes and high levels of blood fats, lower energy intake, and more physical activity.

The project “Health-related Quality of Life and Obesity Treatment in a Controlled Study over Ten years” has been underway since 1993 (the main study) and is supported by the Swedish Council for Working Life and Social Research (FAS).

The Swedish Council for Working Life and Social Research (FAS) is a governmental authority that initiates and finances basic and needs-related research to promote people’s working life, health, and welfare.