Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery

Louisiana State University, Baton Rouge, Louisiana, United States
New England Journal of Medicine (Impact Factor: 55.87). 01/2005; 351(26):2683-93. DOI: 10.1056/NEJMoa035622
Source: PubMed


Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown.
The prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects. We now report follow-up data for subjects (mean age, 48 years; mean body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years.
After two years, the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001). Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period. Two- and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the surgery group than in the control group, whereas recovery from hypercholesterolemia did not differ between the groups. The surgery group had lower 2- and 10-year incidence rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable.
As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline.

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    • "The role of physical activity for optimizing bariatric surgery outcomes has been receiving growing attention, and it is considered an important adjunct to bariatric surgery in the treatment of severe obesity (Herman, Carver, Christou, & Andersen, 2014). Physical activity has been found to be a determinant of the long-term maintenance of weight loss after bariatric surgery (Jakicic, Clark, & Coleman, 2001; Moya et al., 2014), avoiding weight regain and the return of comorbidities associated with this condition (Sjöström et al., 2004). Physical activity is also an important contributor to the prevention or treatment of psychological disorders such as depression or anxiety, and it is associated with improved quality of life after surgery (Bond et al., 2009; King et al., 2013). "
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    ABSTRACT: Obesity has become one of the major health problems in current industrialized societies. The negative impact of morbid obesity (defined as having a Body Mass Index>40 kg/m2) in the health-related quality of life of patients is significant. Bariatric surgery is currently considered an effective treatment to achieve sustained weight loss in patients with severe obesity, after failure of non-invasive treatments. The role of physical activity for optimizing bariatric surgery outcomes is receiving growing attention. In this sense, the aim of this article was to review the scientific literature concerning the psychosocial effects of surgery and physical activity in bariatric patients. The search was performed using Medline and Scopus databases. From a total of 58 articles, 37 articles were included in the review after the application of exclusion and inclusion criteria. In view of the evidence collected in this review, this article finishes with several conclusions and recommendations linking current knowledge with future research and future health-care interventions with this population.
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    • "underscoring the favorable effects of bariatric surgery on diabetes control ( Sjöström et al . , 2004 ) . Overall mortality during a follow - up period up to 15 years was lower in the surgical group with an adjusted cumulative hazard ratio of 0 . 71 ( Sjöström et al . , 2007 ) ."

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    • "Malabsorptive procedures such as gastric bypass limit the absorption of food. Weight loss after bariatric surgery has beneficial effects on the components of the metabolic syndrome including improving insulin sensitivity, lipid profile as well as reducing long-term mortality.20 36 It also has specific effects on liver histology including reduced steatosis, steatohepatitis and fibrosis.19 "
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