Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 Jun 28;7(26):39216-39230.
doi: 10.18632/oncotarget.9581.

The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials

Ji Cheng  1 , Jinbo Gao  1 , Xiaoming Shuai  1 , Guobin Wang  1 , Kaixiong Tao  1
Affiliations
Meta-Analysis

The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials

Ji Cheng et al. Oncotarget. .

Abstract

Background: Bariatric surgery has emerged as a competitive strategy for obese patients. However, its comparative efficacy against non-surgical treatments remains ill-defined, especially among nonseverely obese crowds. Therefore, we implemented a systematic review and meta-analysis in order for an academic addition to current literatures.

Methods: Literatures were retrieved from databases of PubMed, Web of Science, EMBASE and Cochrane Library. Randomized trials comparing surgical with non-surgical therapies for obesity were included. A Revised Jadad's Scale and Risk of Bias Summary were employed for methodological assessment. Subgroups analysis, sensitivity analysis and publication bias assessment were respectively performed in order to find out the source of heterogeneity, detect the outcome stability and potential publication bias.

Results: 25 randomized trials were eligibly included, totally comprising of 1194 participants. Both groups displayed well comparability concerning baseline parameters (P > 0.05). The pooled results of primary endpoints (weight loss and diabetic remission) revealed a significant advantage among surgical patients rather than those receiving non-surgical treatments (P < 0.05). Furthermore, except for certain cardiovascular indicators, bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters (P < 0.05). Additionally, the pooled outcomes were confirmed to be stable by sensitivity analysis. Although Egger's test (P < 0.01) and Begg's test (P<0.05) had reported the presence of publication bias among included studies, "Trim-and-Fill" method verified that the pooled outcomes remained stable.

Conclusions: Bariatric surgery is a better therapeutic option for weight loss, irrespective of follow-up duration, surgical techniques and obesity levels.

Keywords: Pathology Section; bariatric surgery; meta-analysis; obesity; systematic review.

PubMed Disclaimer

Conflict of interest statement

We declare that there is no conflict of interest among all included authors.

Figures

Figure 1
Figure 1. Selection flow chart and risk of bias summary
A. Flow chart of the entire selection process; B. Risk of bias summary.
Figure 2
Figure 2. The forest plot of weight loss (kg) in terms of follow-up duration
Figure 3
Figure 3. The forest plot of weight loss (kg) in terms of surgical techniques
Figure 4
Figure 4. The forest plot of weight loss (kg) in terms of obesity levels
See this image and copyright information in PMC

References

    1. Dietz WH, Baur LA, Hall K, Puhl RM, Taveras EM, Uauy R, Kopelman P. Management of obesity: improvement of health-care training and systems for prevention and care. Lancet. 2015;385:2521–2533. - PubMed
    1. UK NCGC . Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43. London: National Institute for Health and Care Excellence (UK); 2014. - PubMed
    1. Stegenga H, Haines A, Jones K, Wilding J. Identification, assessment, and management of overweight and obesity: summary of updated NICE guidance. BMJ. 2014;349:g6608. - PubMed
    1. Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, Bucher HC, Nordmann AJ. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934. - PMC - PubMed
    1. Yanovski SZ, Yanovski JA. Long-term drug treatment for obesity: a systematic and clinical review. JAMA. 2014;311:74–86. - PMC - PubMed