A Comparison of the Mini-gastric Bypass, Commercial Diet Plan and Standard Care for Obese Patients

R Rutledge, MD. The Center for Laparoscopic Obesity Surgery

 Recently “Weight Watchers” funded a multi-institutional trial comparing a free access to “Weight Watcher’s” Commercial plan to “standard care” as recommended by patients’ local physician. The purpose of this study was to include similarly sized patients who underwent Mini-Gastric Bypass (MGB) as a comparison to this published trial of a commercial weight loss diet and exercise program.

Materials and Methods
Patients in the reported commercial plan were 86-88% female, weight 87 kg, height 1.66 m, BMI 31. 196 MGB patients were selected with similar demographics and the outcomes were compared. For purposes of this study BMI of 19 to 25 classified as “healthy weight.” BMI is 25.1 to 29 classified as “overweight” and may incur moderate health risks. BMI is 30 or more considered to be obese and linked to increased risk of serious health problems.

Results
The MGB patients were heavier at 99 kg and BMI was greater at 36.
Almost half of both diet programs dropped out (39 and 46%). It can be assumed from other reports, that they returned to their pre treatment weight or more.
Weight lost at one year was -5 and -2.3 kg in commercial and “standard care” groups respectively. The starting – end BMI was: 31 – 30, 31 – 31 respectively. All patients were “Obese” both before and after 1 year of nonsurgical therapy.
If we include the roughly 50% drop out rate the mean weight loss for the commercial group and standard groups drops to 3 kg and 1.5 kg or less.
The estimated time spent per year for the commercial plan was a weekly meeting for 2 hours with 1 hour pre and post meeting travel and preparation time. For one year the time would be 156 hours.
In contrast MGB patients went from a mean of 99 kg to 68 kg and BMI dropped from 36.1 (Obese) to 24.9 (Healthy weight).
Conclusion:
156 hours and 1 year in a commercial program, offered for free; resulted in a mean weight loss of 3-5 kg, and a change in 1 point of BMI and patients remained obese and at risk for the serious consequences of obesity. On the other hand in this low risk group MGB resulted in major weight loss, 31 kg, and BMI moved form Obese to a healthy weight classification. Although reported as having “twice the weight loss” of standard therapy, this commercial program makes very little or no impact on the calculated health risks of these patients. Commercial diet programs and standard therapy fail to get participants to a Healthy weight and instead use up hundreds of hours of effort for little gain. On the other hand the Mini-Gastric Bypass is a short simple operative procedure that lasts only 30 minutes and successfully converts obese patients into health weight patients.

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