Studies of operated and nonoperated obese patients. An interim report on the Scandinavian Obesity Project

Abstract

For 2 years, 12 Danish hospitals have conducted a randomized clinical trial to evaluate the hazards and benefits of jejunoileal bypass operations for severe obesity. At present (January, 1976), there are 92 operated and 46 unoperated patients. There has been no mortality in the operated group. One control patient has died. Weight loss is significantly better in the operated group, but not always satisfactory. The well-known postoperative complications have not been deterring in frequency or seriousness. On the whole, but not invariably, the operation has been followed by an improvement in psychosocial status.

The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation

“…Two RCTs 34,39,[58][59][60] and one cohort study with a concurrent control group [62][63][64][65][66][67][68][69][70] assessed the clinical effectiveness of surgery compared with non-surgical interventions ( Table 8, appendix 8). Andersen and colleagues 34,39 compared GP with a VLCD, while the other two studies compared conventional treatment or medical management, defined as the best non-surgical options available, with gastric surgery (Swedish Obese Subjects (SOS)) [62][63][64][65][66][67][68][69][70] or jejunoileostomy (Danish Obesity Project (DOP)).…”

“…Andersen and colleagues 34,39 compared GP with a VLCD, while the other two studies compared conventional treatment or medical management, defined as the best non-surgical options available, with gastric surgery (Swedish Obese Subjects (SOS)) [62][63][64][65][66][67][68][69][70] or jejunoileostomy (Danish Obesity Project (DOP)). [58][59][60] The methodological quality of the studies was compared using a modified version of the criteria identified by Spitzer and colleagues 30 ( Table 7 ). The RCT by Andersen and colleagues was of good quality, 34,39 while the other two studies lacked consideration of key elements of methodological quality.…”

“…The RCT by Andersen and colleagues was of good quality, 34,39 while the other two studies lacked consideration of key elements of methodological quality. [58][59][60][62][63][64][65][66][67][68][69][70] All three studies adequately discussed outcomes, eligibility criteria, patient attrition and the generalisability of findings. While none of the studies blinded the assessment of outcomes, this was expected given the difference in treatments compared.…”

“…Two studies assessed QoL (SOS 66 and DOP [58][59][60] The DOP study 59 examined the QoL of patients who had a jejunoileostomy and those in receipt of medical management through the completion of a questionnaire at least 15 months following randomisation. On somatic symptoms, patients with a jejunoileostomy had significantly (p < 0.05) lower breathlessness (dyspnoea), precordial pain, heartburn, low back pain, pain in hips/knees/ ankles, excessive sweating, heat intolerance, cold intolerance and dermal irritation compared with those on medical management.…”

“…39,59,71 Comparison of later complications between GP and VLCD showed significantly (p < 0.05) greater occurrence of vomiting among GP patients (52% versus 0%) but less irritability and low spirits (0% versus 33%). [58][59][60] Other complications did not differ significantly.…”