BARIATRIC SURGERY VS CONVENTIONAL DIETING IN THE MORBIDLY OBESE

Weight loss and psychosocial events have been compared between low cal orie conventional diet (n = 11) or following obesity surgery (n = 17). Interviews were > 9 months following initiation of treatment. After s urgery significantly less hunger was experienced (surgery 76% [13/17] vs diet 18% [2/11] p < 0.01) and less will-power was required to stop eating (surgery 88% [15/17] vs diet 27% [3/11] p < 0.001). More dieter s stopped eating because of 'figure and health' (surgery 12% [2/17] vs diet 64% [7/11] p < 0.01) whereas postoperative patients stopped due to vomit avoidance (surgery 53% [9/171 vs diet 0% [0/11] p less-than-o r-equal-to 0.05). More of the postoperative group were employed (surge ry 76% [13/17] vs diet 18% [2/11] p < 0.005). Following surgery there were subjective appearance improvements (surgery 94% [15/16] vs diet 5 0% [5/10] p < 0.01) and fewer social limitations (surgery 69% [11/16] vs diet 27% [3/11] p less-than-or-equal-to 0.05). Physical activity im proved (surgery 73% [11/15] vs diet 18% [2/11] p < 0.01). Although bot h groups continue to feel 'fat' at times, more dieters think other peo ple view them as obese (surgery 35% [6/17] vs diet 91% [10/11] p less- than-or-equal-to 0.05). Satisfaction with weight control method was gr eater following surgery (surgery 100% [16/16] vs diet 33% [3/9] p < 0. 005). Enforced behavior modification (vomit avoidance) is the mechanis m of action of gastric restrictive surgery. Physical activity increase s, and satisfaction with weight loss method is greater, after surgery. Employment is greater (probably self selection) in the post-surgical group. We found that comparing greater-than-or-equal-to 9 months follo wing surgery or beginning a conventional diet, the morbidly obese have a more positive response to surgery.