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UB, BlueCross BlueShield Launch Study of Nonsurgical Obesity Treatments

Posted on: Friday, 10 March 2006, 09:00 CST

By Henry L. Davis

It's the dieter's dream, a weight-loss program that takes the pounds off and keeps them off.

The goal eludes so many. However, a major research project being launched in Buffalo may improve chances of success.

UB and BlueCross BlueShield of Western New York announced Tuesday a five-year, $5 million study to look at weight-loss alternatives to surgery for the severely obese.

The study will examine four different weight-loss regimens, comparing their cost and effectiveness to surgery.

"It's essential that alternative, nonsurgical approaches to help people who are severely overweight be evaluated," said Dr. Michael F. Noe, principal investigator. "We need to determine if these new approaches are safe, doable and cost-effective."

It's obvious from our expanding waistlines that such research is timely.

Nearly two-thirds of adults in the United States are overweight, and 31 percent are obese -- 30 or more pounds over a healthy weight, according to the Centers for Disease Control and Prevention. That's an increase from 15 percent in the late 1970s.

The growth in obesity has led to skyrocketing demand for bariatric surgery, including gastric bypass procedures. It's estimated that more than 170,000 surgeries were done in 2005 at a cost of about $4.5 billion.

But overall spending on obesity and its related illnesses, including diabetes and stroke, is much greater -- $117 billion and growing, according to a report by the U.S. Surgeon General.

The research initiative is necessary and urgent because the costs to society and the economy are far too great, said Alphonso O'Neil- White, president and chief executive officer of BlueCross BlueShield, which is sponsoring the study.

Bariatric surgery has been shown to be helpful for the severely obese, and even more effective than diet and exercise alone. But while many patients meet the criteria for surgery, the surgery is risky, expensive and not always an attractive or available option.

The dilemma for physicians and insurers is that they lack a gold- standard alternative that's effective, O'Neil-White said.

The study, to be conducted in the Center for Preventive Medicine in the UB School of Public Health and Health Professions, will involve 280 BlueCross BlueShield subscribers who will be divided into four groups.

The first group will follow a low-calorie diet of between 1,200 and 1,500 calories a day and participate in behavioral treatment.

The second will follow a very-low-calorie diet of 800 calories daily for 12 weeks, then switch to the low-calorie diet, and participate in behavioral treatment.

The third group will follow a low-calorie diet, with behavioral treatment and medication.

The fourth will follow the very-low-calorie diet for 12 weeks, with behavioral treatment and medication.

The behavioral treatment includes exercise, education and motivational strategies. Those who receive medication will get one of two weight-loss drugs: orlistat, also known as Xenical, which blocks some fat from being absorbed by the body, or sibutramine, also known as Meridia, which acts on the appetite control centers in the brain.

The investigators theorize that those who stay on the very-low- calorie diet and receive medication and behavior treatment will achieve the best results. The trickier part, of course, will be preventing the predictable backsliding.

Said Noe: "I hope we demonstrate that we can get people to take off weight and keep it off."

e-mail: hdavis@buffnews.com

Source: Buffalo News

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