For severely obese people, gastric bypass surgery can be the surest, and the most cost-effective, way to weight loss, a new study found.

Surgeries are expensive, but their long-term economic benefits, in terms of improvements in health and life quality, are greater than traditional weight-loss options such as diet, exercise and medication, the National Evidence-based Healthcare Collaborating Agency said in its recently released research.

“They are costly, but far more effective in treating obesity. Our analysis into their long-term cost-effectiveness, using the same methods as the World Health Organization, suggests that a surgery can, thus, be a reasonable choice,” the study said.

The NECA research is the first of its kind conducted here on weight-loss operations, which are becoming increasingly popular with the growth of the obese population.

Official statistics put the number of Koreans going under the knife for weight loss reasons at 778 in 2009, up from 125 in 2003.

In 1998, only 17 in 1,000 Koreans were considered severely obese, or had a body mass index of 35 or higher. The BMI is a measurement of obesity, defined as the individual’s body mass divided by the square of his or her height. The ratio jumped to 71 by 2010, more than quadrupling in 12 years.

In the U.S., where such surgeries are much more common, 220,000 people received them in 2008.

Bariatric surgeries are recommended only for high-risk, severely obese patients.

They cost around 10 million won ($8,800) in Korea, according to clinics.

Three types of operation are most common: 1) Roux en-Y gastric bypass surgery, which staples off a part of the stomach and limits food consumption; 2) laparoscopic adjustable gastric banding, which limits the amount of food consumption with an inserted band; and 3) vertical sleeve gastrectomy, which removes around 80 percent of the stomach.

The NECA researchers tracked 261 patients who received those operations from 2008 to 2011 and 224 others who opted for non-surgical treatments during the same period.

The non-surgical methods include exercise, dietary counseling and medication.

The researchers found that the expected lifelong medical expense associated with obesity and related diseases was higher for the surgical group at 17.9 million won, as it includes the surgery expense itself. The figure for the non-surgical group stood at 16.4 million won.

The extra economic burden on the surgical group, however, is not high, the researchers judged, given the improvements that the group reported in weight loss, health and quality of life.

Those in the surgical group cut down their weight by 22.6 percent on average, while the non-surgical group reported just a 6.7 percent loss.

The former also reported significant declines in obesity-related diseases, such as diabetes, high blood pressure, and hyperlipidemia, or high levels of fat in the blood.

A large discrepancy was found in the quality of life after the medical interventions. Those who underwent surgeries showed a statistically meaningful improvement in their quality of life.

“Unproven methods for weight loss are being used recklessly for commercial purposes. I hope the results are useful in helping obese patients,” said Kwon Jin-won, the chief researcher in the study. 

By Lee Sun-young and Kim Young-won
(milaya@heraldcorp.com) (wone0102@heraldcorp.com)