World Journal of Surgery

, Volume 43, Issue 3, pp 758–762 | Cite as

Bariatric Surgery Versus Lifestyle Intervention in Class I Obesity: 7–10-Year Results of a Retrospective Study

  • Antonio VitielloEmail author
  • Luigi Angrisani
  • Antonella Santonicola
  • Paola Iovino
  • Vincenzo Pilone
  • Pietro Forestieri
Original Scientific Report



The American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation of Surgery for Obesity (IFSO) have both stated that bariatric surgery (BS) should not be denied in Class I patients. However, lifestyle intervention (LI), such as diet plus gym programs, is still considered the preferred approach for subjects with a BMI ranging from 30 to 35 kg/m2. The aim of this study was to retrospectively compare results of LI and BS in patients in Class I obesity.


Retrospective analysis of prospective maintained databases of two centers for the “Interdisciplinary Treatment of Obesity” was performed. All patients in Class I obesity and follow-up >7 years were included in the study. Subjects were divided into two groups: BS group that included patients who had undergone surgery and LI group that included patients who underwent lifestyle intervention (LI). Percentage of excess body mass index loss (%EBMIL) and comorbidities remission were recorded.


Seventy-six patients were included in the study. Fifty-six subjects were submitted to surgery (BS group); 20 subjects were treated with nonsurgical approach (LI group). In BS group, 34 underwent laparoscopic adjustable gastric band, 13 laparoscopic sleeve gastrectomy (LSG), and 9 laparoscopic Roux-en-Y gastric bypass. EWL% resulted significantly higher in BS group at 1, 3, 5, 7 and 10 years (p < 0.01).


Bariatric surgery is more effective than LI for patients in Class I obesity. Due to its versatility, low-risk profile and high-effectiveness LSG could be the standard intervention for these patients.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all patients submitted to surgery and included in the study.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Antonio Vitiello
    • 1
    Email author
  • Luigi Angrisani
    • 2
  • Antonella Santonicola
    • 3
  • Paola Iovino
    • 3
  • Vincenzo Pilone
    • 3
  • Pietro Forestieri
    • 3
    • 4
  1. 1.Department of Advanced Biomedical SciencesUniversity of Naples Federico IINaplesItaly
  2. 2.General, Laparoscopic and Emergency Surgery UnitSan Giovanni Bosco HospitalNaplesItaly
  3. 3.Department of Medicine, Surgery, and DentistryUniversity of SalernoSalernoItaly
  4. 4.Department of Clinical Medicine and SurgeryUniversity of Naples “Federico II”NaplesItaly

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