This study http://archsurg.jamanetwork.com/article.aspx?articleid=2362353 published in JAMA Surgery 07/01/15 is making headlines the past few days on various news services. The attention-getting headlines proclaim that bariatric surgery patients had better weight loss results at 3 years than those in the study who did not have surgery but who had “intensive lifestyle weight loss intervention.” I’m all about weight loss and improving life for people with diabetes, right, so you’d reckon I’d be excited about this.
When I did a Google News search I found more than 150 headlines about this one study such as:
Weight-Loss Surgery Edges Out Lifestyle Changes For Type 2 Diabetes
The question in my skeptical mind is, WHAT INTENSIVE WEIGHT LOSS LIFESTYLE INTERVENTIONS WERE DONE?
This new study included instructing the non-surgical patients in lifestyle modification in line with the Diabetes Prevention Program (DPP) http://care.diabetesjournals.org/content/25/12/2165.full published in 2002. DPP sought a way to keep those at high risk for development of T2DM from reaching that diagnosis. The DPP includes weight loss, increased physical activity, and training/encouragement by health coaches with frequent contact to help keep participants on plan. The weight loss was achieved through low-fat intake in the diet + reduced calorie levels + exercise. Participants used journals to keep track of their fat and calorie intake daily; they were given a food scale, measuring cups/spoons, etc. to accurately count their intake. Goal weight loss 7% of starting body weight.
So, let me get this straight. This study published in JAMA Surgery last week touts bariatric surgery results exceeding those of “intensive weight loss lifestyle interventions” which consisted of eating a low-fat, reduced-calorie diet + support from health coaches. Well, then. I learned to look at studies with a critical eye and to read below the title/headline or the abstract (thank you, Vanderbilt University School of Nursing) and it doesn’t take much reading to see what they’ve done here.
A true drastic method for weight loss (bariatric surgery) is being compared to a moderate method for weight loss (low-fat, reduced-calories, increased activity) that has been proven through past studies as fairly ineffective. *shoulder shrug* So what’s to get excited about here? NOTHING. This illustrates something that women have known for years – if you want to look great when out at a bar, hang out with your less attractive friends. Really. This study shows that bariatric surgery results are great, when compared to something we already know is not super-effective.
How about a study where a drastic method of weight loss is compared to (what is often termed) a drastic method of weight loss? What would the results of a study look like that compared bariatric surgery to LCHF eating? What would the side effects and/or complications data look like? What would be the financial costs of bariatric surgery versus LCHF eating?
Let’s see that study. Let’s see bariatric surgery (drastic, extreme, expensive, possibly dangerous, etc.) take on a method that has been shown effective. I’d like to see the comparison of surgery vs. LCHF nutrition. I’m sure the largest insurers in the country would be quite interested to see the costs to them for surgery vs. LCHF. Employers would be interested to see the time away from work needed for bariatric surgery vs. time away from work for LCHF.
This is not an argument against bariatric surgery. This is argument against bad science. And shameless self-promotion.