Obesity Treatment 197after one year, weight losses average at 50 percent of excess weight. In fact,
Stunkard (1984, 171) stated, “Severe obesity... is most effectively treated
by surgical measures, particularly ones that reduce the size of the stomach
and of its opening into the large gastrointestinal tract.” More recently,
researchers in Sweden have carried out the large-scale Swedish Obese
Subjects (SOS) study which explored nearly 1,000 matched pairs of patients
who received either surgery or conventional treatment for their obesity
(Torgerson and Sjostrom, 2001). The results showed an average weight loss
of 28 kg in the surgical group after 2 years compared to only 0.5 kg in the
conventional group. After 8 years, the weight loss in the surgical group
remained high (average of 20 kg), whilst the control group had gained an
average of 0.7 kg. The weight loss in the surgical group was associated with
a reduction in diabetes and hypertension at 2 years and diabetes at 8 years.
This study indicated that surgery can be effective for both weight loss and
maintenance and brings with it a reduction in the risk factors for cardio-
vascular disease. The surgical management of obesity has been endorsed
Figure 9.4 Gastric bypass. (Source: After J.G. Kral, Surgical interventions for
obesity, in K.D. Brownell and C.G. Fairburn (eds.), Eating Disorders and
Obesity, New York: Guilford Press, 1995, pp. 510–15.)
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