Nfld. & Labrador

Battling obesity: Doctor says weight loss surgery works, diets don't

When it comes to keeping weight off, bariatric surgeries are better than dieting. That's according to a St. John's doctor who's been quoted by the New York Times.

Dr. Laurie Twells says 95 per cent of dieters gain the weight back

Surgery rather than dieting works when it comes to keeping the weight off, research shows. (

An associate professor at Memorial University's School of Pharmacy says when it comes to keeping weight off, bariatric surgeries yield better results than diets do.

In an interview with The St. John's Morning Show, Dr. Laurie Twells, a clinical epidemiologist, said most people lose five to 10 per cent of their body weight while dieting, but that 95 per cent of those people will regain the weight.

People lose weight, they regain it, they lose it again.- Dr. Laurie Twells

"That's not to say they won't keep losing it. Losing weight is quite easy, compared to keeping it off. But the weight sort of yo-yos. People lose weight, they regain it, they lose it again."

According to Twells, dieters typically regain more weight than initially lost. Earlier this month, the associate professor shared her views in an interview with The New York Times

Twells says most patients who undergo bariatric surgery have struggled for years to lose weight and keep it off. (Shutterstock)

Surgically reducing the size of a stomach forces a patient to eat less food. Surgery also changes the structure of the stomach, it reduces hormones and can change "the metabolic profile of a patient."

"With bariatric surgery, a patient, for example, might lose on average 100 pounds. And even if they gain back 20 or 30 [pounds] over a period of time, you're still 70 pounds up," she said. 

Surgery specifics

Twells said there are three main procedures that fall under the scope of bariatric surgery: banding, Roux-en-Y and the gastric sleeve.

In banding, an inflatable band inserted around the stomach can be adjusted by the patient. When inflated like a balloon, the size of the stomach can be decreased.

The gastric sleeve, which removes part of the stomach, is the preferred bariatric surgery at Eastern Health. (CBC)

But Twells said banding has become less popular in recent years because it hasn't shown to be an effective weight loss strategy. 

The Roux-en-Y procedure creates a smaller stomach pouch, while the gastric sleeve — the procedure preferred by Eastern Health — permanently removes a portion of the stomach.

Twells said the laparoscopic surgeries are done through small incisions, and are no longer considered risky, with complication rates in Newfoundland and Labrador on par with the rest of North America. 

She said she hasn't encountered a patient yet who wouldn't recommend the surgery to someone battling severe obesity but, unfortunately, a number of people in the province will never receive bariatric surgery.

Twells estimates the average wait list across Canada is four to five years. 

Dr. Laurie Twells of Memorial University says a lot of money has been spent on preventing obesity, with poor results. (

A pound of prevention

While some are critical of bariatric surgery, Twells considers it to be a necessary treatment.

"People often say to me, 'Why don't we put that money into prevention?' We're putting all sorts of money into prevention, but we haven't seen anything work," she said. 

We treat people who need to be treated. That's the sort of compassionate society we live in.- Dr. Laurie Twells

National research suggests obesity costs the Canadian economy between $4.7 and $7.1 billion each year. And, according to Twells, patients who haven't yet had surgery often suffer from diabetes, hypertension, high cholesterol, sleep apnea and osteoarthritis.

"They might have issues with mobility, they might have issues with their own physical health which means they don't work as often, and even when they're at work they're not as productive — so some of that costing has been around the health system, but also the cost to society," she said. 

"If people's health is compromised … we treat people who need to be treated. That's the sort of compassionate society we live in," she said. 

With files from the St. John's Morning Show