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    'Belly Fat Better Death Predictor Than BMI'

    The finding that having diabetes risk factors such as high blood sugar were a better predictor of surgical benefit than BMI could have implications for selecting candidates for weight loss surgery, Sjostrom and colleagues conclude.

    Weight loss surgery researcher Edward H. Livingston, MD, of the University of Texas Southwestern Medical Center in Dallas, agrees.

    In an editorial published with the study, Livingston writes that obesity alone may not be associated with reduced life span in some people, especially those who don’t carry extra body fat in their belly area.

    Body fat that accumulates around the midsection, especially around the area's organs, is a serious risk factor for heart attack and stroke.

    “We know that weight loss is a very good treatment for most forms of diabetes,” he tells WebMD. “I think we should be focusing on diabetes and not BMI when we consider who should have this surgery.”

    Bariatric surgeon Mitchell Roslin, MD, agrees that BMI alone is a poor predictor of outcomes from weight loss surgery. But he says the main message from the new research is that the surgery prevents heart attack and stroke deaths in many patients.

    Roslin is chief of obesity surgery at Lenox Hill Hospital in New York City.

    “Heart attack and stroke are major killers of obese people,” he tells WebMD. “This study proves this surgery saves the lives of obese patients with a high risk for heart disease.”

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