Is surgery really the best way to deal with obesity?

I received an e-mail message from Dr. Justine Davies, the editor of The Lancet Diabetes & Endocrinology, announcing a series of review articles on bariatric surgery for treatment of obesity.

Bariatric surgery, she says,

is the most effective treatment for both obesity and type 2 diabetes. In many people with type 2 diabetes, bariatric surgery not only limits disease progression, but also reverses complications.

She asks: So why is this procedure not being used more often to treat
patients with obesity?

Bariatric surgery has substantial benefits in terms of weight loss, metabolic status, and quality of life. It is safe and effective, and the future savings made through prevention of comorbid diseases could counterbalance its high cost. The surgery should, therefore, be available as an option to use when appropriate, and not only when all other options have been eliminated. Bariatric surgery offers a real opportunity for preventing comorbid diseases and complications of obesity. If it is only used as a final resort, this opportunity will be missed.

I can think of several good reasons: pain and suffering, treatment complications, questionable long-term prognosis, and cost, for starters.

Prevention is a better option.

If only we knew how….

Here are the papers:

• Editorial: Bariatric surgery: why only a last resort?
• Comment: Is bariatric surgery safe?
• Comment: Quality of life after bariatric surgery
• Series 1: Reversal of organ damage after bariatric surgery
• Series 2: Mechanisms of bariatric surgery
• Series 3: Bone loss after bariatric surgery
• Series 4: Are criteria for bariatric surgery fit for purpose?