For Most, Diet and Exercise Alone Not Sufficient Obesity Treatment Method,
Top Journal Says



Published in March/April 2015 Issue             


New commentary published in the journal Lancet Diabetes & Endocrinology, claims that once people develop obesity it’s next to impossible for people return to a healthy weight without bariatric surgery. It says bariatric surgery is the only available treatment to show long-term effectiveness.

The commentary received some media attention, including in the Los Angeles Times where one of the authors, Christopher N. Ochner, a clinical psychologist from Mt. Sinai Hospital in New York, whose research focuses on obesity prevention and treatment for adolescents said “the average adult with sustained obesity has less than a 1% chance” of returning to and maintaining a healthy body weight without surgery.

The authors also suggest in their commentary entitled, Treating Obesity Seriously: When Recommendations for Lifestyle Change Confront Biological Adaptations, “that few individuals ever truly recover from obesity and that those show are able to get back to a healthy weight via diet and exercise still have “obesity in remission” and are “biologically different from individuals of the same age, sex and bodyweight who never had obesity.” They say, these biological adaptations need to be addressed for weight loss to be sustainable.

The authors provide clinical recommendations for obesity and treatment, which include, proactively addressing prevention with overweight patients; consider biologically-based interventions. Lifestyle modification alone is likely to be insufficient. Consider medication or surgery, when appropriate; and recommend bariatric surgery when appropriate, because bariatric surgery is the only effective long-term treatment for obesity available.


John Morton, MD

“Bariatric surgery remains underutilized despite significant evidence that it is our most effective treatment for obesity,” said John Morton, MD, president, ASMBS. “There is a real need for both patients and the medical community to better understand the biological factors behind obesity and understand which treatments can best address them in the long-term. The evidence is there for bariatric surgery and it’s time to put this evidence into action.”

Dr. Morton added, “We should do everything we can to prevent obesity, but we cannot forget about the millions of people who have obesity and offer evidence-based treatments that we know will stand the test of time.”