Bariatric treatments for adult obesity - Institute of Health Economics

Maciejewski et al., 2005 65Avenell et al., 2004 2McTigue et al., 2003 66Poobalan et al., 2007 67HrQoL outcomes, including depression, were not consistently improved in RCTs of weight loss. The overall quality of these clinical trials was poor.Better-designed RCTs using standardized HrQoL measures are needed in order to determine the extent to which weight loss improves HrQoL.Orlistat, sibutramine, and metformin appear beneficial for the treatment of adults with obesity. Exercise and/or behavioural therapy appear to improveweight loss when added to diet. Low-fat diets with exercise, with or without behavioural therapy, are associated with the prevention of type 2 diabetesand hypertension.Long-term weight loss was also associated with reduced risk of developing diabetes, and may be beneficial for cardiovascular disease.Limited evidence suggests that counseling interventions may promote modest weight loss in the overweight (BMI 25–29.9 kg/m 2 ). Effective treatmentsfor people with a BMI >30 kg/m 2 include intensive counseling and behavioural interventions for lifestyle change, and pharmacotherapy. Surgery iseffective in reducing weight for people with a BMI of 35 kg/m 2 or greater.Considering the methodological limitations, benefits of weight loss on all-cause mortality for overweight/obese patients are meager. The most importantexplanations are intentionality, self-reporting of weight loss, and the time lapse between last recorded weight loss measurement and the mortalityoutcome.Bariatric treatments for adult obesity 150