A new study suggests that weight loss surgery may be more effective than conventional diet and exercise programs in helping obese patients recently diagnosed with Type 2 diabetes.

While caution is required in interpreting the longer-term benefits of surgery and weight loss, the study "presents strong evidence" to support the early consideration of that approach in those patients, Australian researchers concluded in the study, published today in the Journal of the American Medical Association.

While acknowledging that weight loss surgery is often effective, some Western Pennsylvania experts noted that conventional weight loss programs also can be beneficial.

Patients in those programs may need more help than that provided in the Australian study, said Dr. Bret Goodpaster, an associate professor in the division of endocrinology and metabolism at the University of Pittsburgh School of Medicine.

The Australian researchers believe their study is the first randomized controlled trial comparing surgically induced weight loss with conventional therapies for obese patients with Type 2 diabetes. The study enrolled 60 patients who had been diagnosed with diabetes for less than two years.

Some patients were randomly assigned to receive adjustable gastric banding surgery. The procedure, usually performed laparoscopically, involves placing an adjustable band around the upper part of the stomach to limit food consumption.

Other patients were randomly assigned to a conventional treatment group that gave them access to doctors, nurses, and diabetes educators and to individualized lifestyle modification programs. Patients met with at least one treatment team member every six weeks during the two-year study period.

Researchers found that after two years, 73 percent of patients in the surgical group achieved remission of Type 2 diabetes compared with 13 percent in the conventional treatment group.

The study found that relief from diabetes was primarily linked to weight reduction. Unlike the surgery patients, the conventional therapy group showed minimal weight loss. No serious complications occurred in either group.

The study, led by Dr. John Dixon of the Monash University Medical School, was funded by the university through an unrestricted grant from Allergan, which provided materials for the surgeries along with another company, Applied Medical. But researchers said the companies had no other role in the study.

In an accompanying editorial, Drs. David Cummings and David Flum of the University of Washington in Seattle said the general applicability of the findings remains unclear, in part because study participants had relatively mild diabetes.

But they noted that in other, more complex weight loss surgeries -- gastric bypass and biliopancreatic diversion -- diabetes typically resolves within a few days or weeks, "long before substantial weight loss has occurred."

They said it may be time to view bariatric surgeries "as interventions about which all patients with diabetes should be informed and given access."

Dr. Joseph Colella, director of bariatric surgery at Allegheny General Hospital, said the weight reduction and remission from diabetes noted in the study come as no surprise to weight loss surgeons.

"We see it in our daily practice all the time," he said.

Conventional therapies should be considered if obesity results from overeating, said Dr. Daniel Gagne, director of bariatric surgery at West Penn Hospital.

But he noted that many of his surgical patients "spend their whole lives on diets" and still cannot achieve significant weight loss.

One of his patients, Donald Cypher, said he tried dieting.

"You'd lose a few pounds, but it wouldn't stay off," said Mr. Cypher, 73, of Saxonburg, who was diagnosed with Type 2 diabetes in the 1990s.

Since he had gastric bypass surgery early last year, Mr. Cypher has seen his weight plummet from 281 to 180 pounds. He said his blood sugar levels dropped soon after the surgery.

He takes fewer medications, no longer has a problem with sleep apnea and said he has needed no insulin for two months.

"In retrospect, I wish I'd had it sooner," he said of the surgery.

Besides Dr. Dixon, other co-authors of the study were Drs. Paul O'Brien, Leon Chapman, Linda Schachter, Stewart Skinner, and Michael Bailey of Monash University, Dr. Joseph Proietto of the University of Melbourne, and Julie Playfair and Margaret Anderson of Monash University.