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Benefits Seen 10 Years After Obesity Surgery

Dec. 22, 2004 - Patients do well for at least 10 years after weight loss surgery, a Swedish study shows.

Does the drastic obesity treatment save lives? It's still too soon to tell. But it does cut down on diabetes and measures of heart disease risk, report Lars Sjöström, MD, PhD, of Sahlgrenska University Hospital in Göteborg, Sweden, and colleagues. The findings appear in the Dec. 23 issue of The New England Journal of Medicine.

The researchers compared more than 4,000 severely obese people who underwent weight loss surgery with similar obese people who underwent traditional obesity treatments. The main findings:

  • Two years after surgery, patients' weight decreased by 23.4% vs. a very slight weight gain in those who did not have surgery.
  • Ten years after surgery, patients still weighed about 16% less than they did before surgery. Those who did not have surgery had a 1.6% weight gain.
  • Obesity surgery had no effect on cholesterol levels, but treated patients had lower blood pressure. Other markers of heart disease risk also improved.
  • Obesity surgery lowered patients' risk of developing diabetes and increased their chances of recovering from diabetes.
  • Patients who underwent obesity surgery tended to be more physically active than those who did not have surgery.
  • Patients who underwent obesity surgery tended to eat less than those who did not have surgery.

But the study wasn't able to determine whether obesity surgery cut patients' risk of heart attack, stroke, or death.

"The surgically treated subjects in this study had greater weight loss, more physical activity, and lower energy intake than the control subjects over a 10-year period," Sjöström and colleagues write.

In an editorial accompanying the Sjöström report, Caren G. Solomon, MD, MPH, and Robert G. Dluhy, MD, note that obesity surgery has risks of its own. Adverse events -- aside from death during surgery (a very low 0.25% in the Sjöström study) -- included postoperative infections, bleeding, and life-threatening blood clots in 13% of patients. Other side effects of obesity surgery include ulcers, nutritional problems, and bowel obstruction.

Solomon and Dluhy note that in 2003 there were 100,000 obesity surgeries in the U.S. They warn that while the operation can be very successful, it would be far better to prevent obesity in the first place.

"[Obesity] surgery is currently the most successful approach to 'rescuing' patients with severe obesity and reversing or preventing the development of several diseases associated with obesity," Solomon and Dluhy write. "It would be an even greater success to make these procedures unnecessary."

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