While both surgical and non-surgical treatments led to considerable loss of weight, those who dieted and exercised had to work harder and over a longer period of time than the stomach-stapling group, according to researchers at the Miriam Hospital's Centers for Behavioral and Preventive Medicine, who published their work in the International Journal of Obesity.
"Our findings suggest that it's possible to maintain large weight losses through intensive behavioral efforts, such as changing your approach to eating and exercise, regardless of whether you lost weight with bariatric surgery or through non-surgical methods," said lead author Dale Bond.
He also said that "these findings underscore the need for eating and activity interventions focused on bariatric surgery patients. Future research should focus on ways to increase and maintain physical activity and better monitor psychological parameters in bariatric surgery patients to facilitate optimal long-term weight control."
For their two-year study, the research team chose 315 formerly severely obese patients who had lost an average of 124 pounds and had kept their weight stable for an average of 5.5 years. One-third of them had stomach-stapling done, and the rest had lost their weight through behavior changes. The participants filled out surveys at the start of the two years and at the one-year follow-up about their psychological status (in terms of dietary restraint, feelings of hunger, food cravings, stress levels and depression) and how they maintained their weight.
Daily calorie consumption and weight regain over the two years (about 4 pounds per year) were comparable between the two groups. But the surgical group ate more fat, consumed more fast food, maintained less conscious control over their eating, exhibited higher rates of depression, and were more stressed. They also exercised less than the non-surgical group. Only about a third of the surgical group said they engaged in physical activity at a level that would help them keep the weight off, while 60 percent of the non-surgical group said they did.