August 7, 2013

Google Logo Add Us On GoogleAdd SciAm

Fat Tuesday: Neurosurgery versus bariatric surgery in obesity

A study in the journal Neurosurgical Focus has calculated thate DBS will have to be 83% effective in order for it to be a better choice than gastric bypass for obese patients.

By Stephen L. Macknik

Join Our Community of Science Lovers!

This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American

https://upload.wikimedia.org/wikipedia/commons/thumb/9/91/Parkinson_surgery.jpg/402px-Parkinson_surgery.jpg

Gastric bypass surgery is the most effective method for treating obesity—it’s 97% effective at reducing excess weight by more than 45% at least 1 year post-surgery. Dieting (irrespective of type) averages about 8% loss, though two-thirds of people regain more weight than they lost within 2 years.

So dieting does not work (in general), and gut surgery is very likely to work, but is it possible that neurosurgery will be even better? Deep brain stimulation (DBS) is the latest frontier in neurosurgery, and it is successful at accomplishing behavior change for many patients, including obese patients, but a controlled clinical trial has not yet measured its efficacy. To compare whether DBS or gastric bypass is better, you also need account for complications of each surgical type.

On supporting science journalism

If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.

A study in the journal Neurosurgical Focus has calculated how effective DBS will have to be in order for it to be a better choice than gastric bypass, tasking both efficacy and complication rate into account: it will to be better than 83% effective to beat out gastric bypass at weight loss.

Whether DBS will be beneficial for diabetes remains to be seen.

 

Stephen L. Macknik is a professor of opthalmology, neurology, and physiology and pharmacology at SUNY Downstate Medical Center in Brooklyn, N.Y. Along with Susana Martinez-Conde and Sandra Blakeslee, he is author of the Prisma Prize-winning Sleights of Mind. Their forthcoming book, Champions of Illusion, will be published by Scientific American/Farrar, Straus and Giroux.

More by Stephen L. Macknik

It’s Time to Stand Up for Science

If you enjoyed this article, I’d like to ask for your support. Scientific American has served as an advocate for science and industry for 180 years, and right now may be the most critical moment in that two-century history.

I’ve been a Scientific American subscriber since I was 12 years old, and it helped shape the way I look at the world. SciAm always educates and delights me, and inspires a sense of awe for our vast, beautiful universe. I hope it does that for you, too.

If you subscribe to Scientific American, you help ensure that our coverage is centered on meaningful research and discovery; that we have the resources to report on the decisions that threaten labs across the U.S.; and that we support both budding and working scientists at a time when the value of science itself too often goes unrecognized.

In return, you get essential news, captivating podcasts, brilliant infographics, can't-miss newsletters, must-watch videos, challenging games, and the science world's best writing and reporting. You can even gift someone a subscription.

There has never been a more important time for us to stand up and show why science matters. I hope you’ll support us in that mission.

Thank you,

David M. Ewalt, Editor in Chief, Scientific American

Subscribe