This article is more than 5 years old. Information may no longer be current.
Bariatric surgery reduced mortality rate in severely obese
Surgery reduced the mortality rate by 29%.
Click Here to Manage Email Alerts
Bariatric surgery reduced premature death in patients with severe obesity, according to results from a new study published in The New England Journal of Medicine.
“We show for the first time that surgery against obesity not only leads to long-term loss of weight, it also significantly reduces mortality,” Lars Sjöström, MD, PhD, professor emeritus, Sahlgrenska Academy, Göteborg, Sweden, said in a press release.
The long-term, prospective, controlled Swedish Obese Subjects Study followed more than 4,000 severely obese patients for up to 18 years. Mortality rates among patients who underwent bariatric surgery were 29% lower compared with patients who did not receive the surgery.
Gastric bypass
Obese patients either underwent bariatric surgery or received advice concerning lifestyle changes. Overall, the conventional weight loss treatment was considerably less effective than bariatric surgery, according to the researchers.
After two years, weight decreased by 23.4% in the surgery group compared with an increase of 0.1% in the control group. The researchers found similar findings after 10 years (n=1,703); weight decreased by 16.1% among patients who underwent the surgery but increased by 1.6% among controls.
In addition, patients who underwent the procedure had more favorable rates of recovery from diabetes, hypertriglyceridemia, low levels of HDL cholesterol, hypertension and hyperuricemia. However, recovery from hypercholesterolemia did not differ between the groups. The surgery group also had lower incidence rates of diabetes, hypertriglyceridemia and hyperuricemia compared with controls.
“The mean changes in weight and risk factors were more favorable among the patients treated by gastric bypass than among those treated by banding or vertical banded gastroplasty,” the researchers wrote. However, the gastric bypass technique appears to be the current method of choice over other techniques; the weight loss may be related to altered gut-to-brain signaling, they said.
Five of the 2,010 patients who underwent the procedure died postoperatively (0.25%). Other postoperative adverse events included bleeding, embolism or thrombosis, wound complications and deep infections.
Viable option for obesity
“Bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline,” the researchers wrote.
One limitation is that the study was not randomized, they said.
What causes the lower mortality rate with surgery remains unclear, according to the researchers.
“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,” Sjöström said.
For more information:
- Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741-752.