New research by Aberdeen academics claims surgery is the most effective long-term plan for fighting obesity in adults.
According to a new study by Aberdeen University, surgery is the most cost-effective approach for weight loss in those who are severely obese.
But the research also revealed high quality weight management programmes (WMPs) are effective in reducing weight for up to 10 years in some cases.
The study was funded by the National Institute for Health Research (NIHR).
The review found surgery for obesity had the best long-term weight-loss results and could be a good use of NHS resources, compared with no surgery or weight management programmes on their own.
In the UK, the most common types of surgery for weight loss is bariatric – where the stomach is reduced in size using a band, or by removing a part of it – and gastric surgeries, where surgical staples are used to make the stomach smaller.
Researchers reviewed 236 studies, looking at factors such as effectiveness and value for money of surgery, diet and exercise, and weight management programmes.
Of non-surgical approaches, very low calorie diets produced the best weight loss result at 12 months, but it was unclear if weight loss was any greater than standard WMPs for longer than this.
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Lead author of the study, Professor Alison Avenell, from Aberdeen University, said: “The purpose of this study was to examine the available evidence looking at the effectiveness and cost-effectiveness of different weight management procedures from the perspective of the NHS.
“While the study shows surgical interventions remain much more effective, provision of surgery for obesity management by the NHS is presently very low. Other weight management programmes can be effective in terms of helping people who are severely obese lose weight and are cost-effective for the NHS.”
The research also revealed that adding a very low calorie diet to an existing weight management programme was shown to not be a good use of NHS resources.
But most weight management programmes, including those with very low calorie diets, appeared to be a good use of NHS resources compared with doing nothing at all.
The best result for long-term non-surgical weight loss – over nearly 10 years – came from an intensive plan with a low-fat diet, having a calorie goal, initial meal replacements or meal plans and lots of exercise.
Professor Avenell said: “Obesity is a rapidly increasing, worldwide epidemic. Despite recent scientific advances, no recommended dietary program or medication results in long-term weight loss of more than 10% of body weight for the vast majority of people who attempt these interventions. Hence, surgical intervention is recommended for patients.”
Increasing physical activity to prevent long-term weight regain, and receiving longer-term help with diets or using the drug Orlistat, were also found to help keep weight off.
Meanwhile, Aberdeen nutritionist and author Scott Baptie said: “Aside from confirming that surgery is an effective weight loss treatment, this study has also reiterated the importance of following a ‘high quality’ weight management programme when trying to lose weight.
“There’s no shame in having weight loss surgery if you deeply feel it’s the right choice for you.”