Bariatric Surgery for Severe Obesity Saves Lives

A new study has established that bariatric surgery reduces premature death in patients with severe obesity.

Researchers from the Sahlgrenska Academy (Göteborg, Sweden) examined 4,047 severely obese patients in a long-term follow up of between five and 18 years. Nearly half (2,010) of these patients underwent bariatric surgery, while the remaining patients (2,037) received advice concerning changes in lifestyle, also intended to cause weight loss, some of whom also received medicines for weight loss. The researchers also considered the effects of many biochemical and other variables in the analysis, including smoking, stress, and previous medical history.

The results showed that the average weight change in control subjects was less than 2% during the period of up to 15 years during which weights were recorded. The maximum weight losses in the various surgical subgroups were observed after one to two years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. The mortality among patients who had undergone surgery was 29% lower than it was among the other patients. The results were published in the August 23, 2007, issue of The New England Journal of Medicine (NEJM).

"The group receiving conventional treatment had even increased somewhat in weight after 10 years, while patients who had undergone surgery decreased in weight by 16%, on average,” said co-author Prof. Lena Carlsson, M.D., from the department of metabolism and cardiovascular research. "Bariatric surgery is the only treatment for severe obesity for which there is scientific evidence that it reduces mortality.”

"The mechanisms behind the lower mortality are not clear. It seems that the reduction in risk depends less upon the actual loss of weight itself than on the fact that the patients have undergone surgery against obesity,” said lead author Prof. Lars Sjöström. M.D., Ph.D. "This observation opens new possibilities for discovering previously unknown mechanisms behind the increase in risk associated with obesity, and thus opens the possibility of developing new treatments.”


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