Study to examine obesity treatment

Clinical researchers at the University of Bristol are studying treatment options for obesity, after a survey on behalf of National Institute for Health Research (NIHR) found more than four in 10 people in the West have noticed an increase in local obesity levels in the last five years. Despite the findings, the same survey shows that around three-quarters of the public in this region have a clear understanding of the most important causes of obesity: overeating and lack of exercise. This suggests that with obesity levels in the UK having almost trebled in the last 30 years, public understanding is not solving the problem.

Dr Mary Perkins, chief operating officer at NIHR Clinical Research Network: West of England, believes clinical research can help to reframe the debate:

"We've talked about diet and exercise for a long time. This survey shows the message is getting through, but statistics tell us the impact is negligible.

"People need more options. Clinical research is playing a vital role in developing better and more cost effective treatments for people who are obese. It is also looking at the reasons for weight gain, which can help us address long-term solutions for the causes and development of the condition."

The By-Band-Sleeve study, coordinated from the Clinical Trials and Evaluation Unit at the University of Bristol and funded by the NIHR, is underway in 11 hospitals around the country, seeking to address some of these issues.

Current national guidelines recommend that, following a care pathway, surgery is considered for people with severe and complex obesity. This surgery is known as bariatric surgery. Three of the most common types of bariatric surgery operations are: the adjustable gastric band ('Band'), the Roux-en-Y gastric bypass ('Bypass'), and the gastric sleeve ('Sleeve').

At the moment, health professionals do not know which of these three operations is the most effective for long-term weight loss and improvement of health problems and quality of life.

Choice of surgery is based on a combination of clinical opinion and patient choice. Professor Jane Blazeby, the chief investigator for the By-Band-Sleeve study, believes this way of working needs to change.

She said: 'We want to give advice to patients based on clinical evidence, not personal opinion. We need to know which operation is most effective and who it's most effective for. Based on that information, we can make informed decisions about which type of surgery to recommend, safe in the knowledge it is the most cost effective choice for the NHS.

'In the UK, the NHS conducts around 6,000 bariatric operations a year. That may seem a lot, but when you consider there are 1.3 million people here who are morbidly obese, it puts this number into perspective. Bariatric surgery may be an option to help a great many more people to lose weight and improve their health and quality of life, combined with an active change in eating and lifestyle.

'By-Band-Sleeve is the largest study of its kind into bariatric surgery worldwide and it is a complex and long term project. The clinical trials expertise in Bristol is second none and it's helping us change the way we go about applying this kind of research to surgery.'