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Obesity Surgery May Cut Heart Risk

Study Shows Gastric Bypass Operation Modifies Cardiac Risk Factors
By
WebMD Health News
Reviewed by Louise Chang, MD

March 13, 2006 (Atlanta) -- At a time when obesity is epidemic in this country, researchers report that weight loss surgery can help prevent heart disease, strokes, and deaths due to cardiovascular disease.

Researcher John A. Batsis, MD, of the Mayo Clinic in Rochester, says six obese people would have to undergo the surgery to prevent one stroke or heart attack, and 33 people need to have the surgery to prevent one death from heart disease.

"We're not advocating [weight loss] surgery for every obese person," he tells WebMD.

"But for an obese person with risk factors such as a previous heart attack or diabetes, the surgery is an alternative means of lowering cardiovascular disease risk," Batsis says.

Obesity and Heart Risk

Batsis stresses that the surgery should only be performed in conjunction with a diet and exercise program and by experienced surgeons who do at least 50 procedures a year.

More than 6 in 10 Americans are overweight or obese, and the American College of Cardiology and the American Heart Association recognize obesity as a major risk factor for the development of cardiovascular disease.

In 2005, about 170,000 people had weight loss surgery, according to the American Society of Bariatric Surgery.

The study, presented here at the American College of Cardiology's Annual Scientific Session, comes on the heels of a recent decision that expands Medicare coverage for weight loss surgery to people with a body mass index (BMI) of 35 or greater and who have at least one weight-related health problem, such as diabetes.

Cholesterol Improvement After Surgery

The researchers studied 197 obese people who underwent gastric bypass surgery, which shrinks the stomach volume by as much as 90%. People feel full sooner and lose weight. They were compared to 163 obese people who did not have the procedure. All participants were enrolled in a strict diet and exercise program to help them shed pounds.

By three years, "the differences were striking," Batsis says. For example, those who had the surgery lost an average of 77 pounds, while the scale barely moved among those who didn't have the procedure.

There's more. LDL cholesterol levels dropped 40 points, body mass index dropped 15 points, and the percentage of people with diabetes dipped 19% in the surgery group. In contrast, diabetes cases actually rose among the group that didn't have the procedure. The need for cholesterol-lowering medication also dropped 61% in the surgery group, while increasing among the other participants.

Modifying Heart Risk

Using statistical techniques known as risk modeling that take into account a person's risk factors for a disease, the researchers estimated that for every 100 patients in a 10-year period, the surgery would prevent 16 heart attacks and strokes and 4.1 deaths.

Robert Eckel, MD, professor of medicine at the University of Colorado Health Science Center in Denver and president of the American Heart association, agrees that cardiovascular disease risk factors are favorably modified by gastric bypass surgery.

But, he tells WebMD, "the evidence for using this procedure as a means of reducing strokes, heart attacks, and deaths is not in yet. For that we need more study."

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