Doubts cast over long-term benefit of bariatric surgery

A review of more than 30 studies found that diabetic people with moderate obesity lost more weight and had better glucose control over two years if they were treated with bariatric surgery rather than non-surgical alternatives like dieting and medications, a new study suggests.

However, the findings come from a relatively small number of trials performed at only a few academic surgery centers.

More information is needed about how patients fare after two or more years, including complication rates and side effects, before the strategy can be more widely recommended, according to researchers.

"Bariatric surgery for diabetic people who are not severely obese has shown promising results in controlling glucose," Dr. Melinda Maggard-Gibbons, the study's lead author and a surgeon at the David Geffen School of Medicine at UCLA, said.

"However, we need more information about the long-term benefits and risks before recommending bariatric surgery over non-surgical weight-loss treatment for these individuals," she said.

Bariatric surgery, which includes procedures such as gastric banding and gastric bypass, is now commonly used to produce weight loss and help manage related illnesses in people who are severely obese-generally people who are 100 pounds or more overweight.

Bariatric surgery is being advocated as a treatment for diabetes in less-obese individuals, but there is no consensus about whether it's appropriate.

In 2006, the federal Centers for Medicare and Medicaid Services would not approve coverage for patients with lower BMI and diabetes, whereas the US Food and Drug Administration has approved gastric banding for individuals with a BMI of 30 to 35 who have an obesity-related illness.

Before recommending weight-loss surgery for people on the lower end of the obesity spectrum, there needs to be additional and larger studies done to demonstrate the value of the approach, according to the study.

The study is published in the Journal of the American Medical Association.