Weight loss surgery lowers risk of heart attacks, strokes, and death among people who are obese, Swedish researchers report in the January 4 issue of the Journal of the American Medical Association.
While bariatric surgeries such as gastric bypass and gastric banding with the Lap Band and Realize Band do produce massive weight loss, a growing body of evidence, including the new study, suggests that these surgeries may have health benefits that occur independently of weight loss. Bariatric surgery may affect certain metabolic or hormonal changes that reduce risk for heart disease, stroke, and even diabetes.
Each year, about 200,000 people undergo bariatric surgery in the United States, according to the American Society for Metabolic and Bariatric Surgery. While access to bariatric surgery is improving, and a growing number of insurers are covering a wider range of these surgeries, most guidelines for candidacy rely solely on body mass index (BMI), a measurement that takes into account height and weight.
Given the growing list of benefits of weight loss surgery, many experts suggest that there is more to deciding who makes an appropriate candidate than BMI alone. Instead, they argue, the surgery should be targeted at treating a condition that will improve with weight loss, such as heart disease, diabetes, or sleep apnea.
The new study included 2,010 obese people from Sweden who underwent bariatric surgery and 2,037 obese individuals who tried to lose weight through more conventional methods such as lifestyle changes. After 14 years of follow-up, 28 people in the bariatric surgery group died from heart disease or stroke, as did 49 people who tried other methods to lose weight. Overall, there were 234 heart attacks or strokes seen among participants who did not have weight loss surgery and 199 such events among those who did.
Mitchell Roslin, MD, the chief of obesity surgery at Lenox Hill Hospital in New York, says, “The message is clear — bariatric surgery saves lives.”
But “the unfortunate thing is that many patients still need to fight for coverage for bariatric surgery,” he says. “Instead of this battle, bariatric surgery should become standard of care for severely obese patients who are at high risk for heart disease.”
By Denise Mann, editor, PSP