Fact checked byHeather Biele

Read more

June 19, 2023
2 min read
Save

Obesity medication use plummets after bariatric surgery; cardiovascular drug use rebounds

Fact checked byHeather Biele
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Key takeaways:

  • Lipid-lowering and antidiabetic medication use decreased in patients who underwent bariatric surgery vs. those who did not.
  • There was a transient reduction cardiovascular medication use in the surgery group.
Perspective from Jesse Gutnick, MD

Patients who underwent bariatric surgery for morbid obesity had a “substantial and long-lasting reduction” of lipid-lowering and antidiabetic medication use compared with patients who did not undergo surgery.

“Bariatric surgery decreases the prevalence of obesity-related diseases, contributing to longer life expectancy and increasing use of such surgery in patients with morbid obesity,” Joonas H. Kauppila, MD, PhD, professor of clinical epidemiology and gastrointestinal surgery consultant at the University of Oulu in Finland, and colleagues wrote in JAMA Surgery. “Yet, it is unclear how bariatric surgery influences the long-term use of medications for obesity-related diseases, ie, hyperlipidemia, cardiovascular disorders and diabetes.”

Medication use rates among adults who underwent bariatric surgery
Data were derived from Kauppila JH, et al. JAMA Surg. 2023;doi:10.1001/jamasurg.2023.0252.

In a population-based cohort study, Kauppila and colleagues compared 26,396 patients with morbid obesity (median age, 50 years; 66.4% women) who underwent gastric bypass or sleeve gastrectomy with 131,980 matched controls (median age, 50 years; 66.4% women), also diagnosed with morbid obesity, who did not undergo surgery.

The primary outcome was change in lipid-lowering, cardiovascular or antidiabetic medication use.

Lipid-lowering medication

After a median follow-up of 7.1 years in the bariatric surgery group, researchers reported the proportion of patients who used lipid-lowering medication decreased from 20.3% at (95% CI, 20.2-20.5) to 12.9% (95% CI, 12.7-13) 2 years after surgery and 17.6% (95% CI, 13.3-21.8) after 15 years.

After a median follow-up of 5.7 years in the control group, the use of lipid-lowering medications increased from 21% (95% CI, 20.9-21.2) at baseline to 44.6% (95% CI, 41.7-47.5) after 15 years.

Cardiovascular medication

Results also showed that 60.2% (95% CI, 60-60.5) of patients who underwent bariatric surgery used cardiovascular medication at baseline, which decreased after 2 years to 43.2% (95% CI, 42.9-43.4) and increased after 15 years to 74.6% (95% CI, 65.8-83.4).

The use of cardiovascular medication increased among patients who did not undergo surgery from 54.4% (95% CI, 54.3-54.5) at baseline to 83.3% (95% CI, 79.3-87.3) at 15 years.

Antidiabetic medication

At baseline, 27.7% (95% CI, 27.6-27.9) of those in the bariatric surgery group used antidiabetic medication, which decreased to 10% (95% CI, 9.9-10.2) after 2 years and increased to 23.5% (95% CI, 18.5-28.5) after 15 years.

The use of antidiabetic medication increased among patients in the control group from 27.7% (95% CI, 27.6-27.7) at baseline to 54.2% (95% CI, 51-57.5) after 15 years follow-up.

“This large population-based cohort study in Sweden and Finland with up to 23 years of follow-up indicates a long-lasting reduction in the use of lipid-lowering and antidiabetic medication in patients who undergo bariatric surgery compared with matched patients with an obesity diagnosis treated without surgery, while the reduction was only transient for cardiovascular medications,” Kauppila and colleagues concluded.