Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery.
BACKGROUND
Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk, but whether these benefits persist over time is unknown.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Sjöström
Lars
L
Department of Body Composition and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden.
Lindroos
Anna-Karin
AK
Peltonen
Markku
M
Torgerson
Jarl
J
Bouchard
Claude
C
Carlsson
Björn
B
Dahlgren
Sven
S
Larsson
Bo
B
Narbro
Kristina
K
Sjöström
Carl David
CD
Sullivan
Marianne
M
Wedel
Hans
H
D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000209:etiology; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D033461:Hyperuricemia / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000401:mortality / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss