title: Effects of bariatric surgery on mortality in Swedish obese subjects.
abstract: BACKGROUND
  Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality.
  
  
  METHODS
  The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%).
  
  
  RESULTS
  The average weight change in control subjects was less than +/-2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group, 47; surgery group, 29).
  
  
  CONCLUSIONS
  Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.
authors: Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. lars.sjostrom@medfak.gu.se
authors: Lars
authors: L
authors: Sjöström
authors: Kristina
authors: K
authors: Narbro
authors: C David
authors: CD
authors: Sjöström
authors: Kristjan
authors: K
authors: Karason
authors: Bo
authors: B
authors: Larsson
authors: Hans
authors: H
authors: Wedel
authors: Ted
authors: T
authors: Lystig
authors: Marianne
authors: M
authors: Sullivan
authors: Claude
authors: C
authors: Bouchard
authors: Björn
authors: B
authors: Carlsson
authors: Calle
authors: C
authors: Bengtsson
authors: Sven
authors: S
authors: Dahlgren
authors: Anders
authors: A
authors: Gummesson
authors: Peter
authors: P
authors: Jacobson
authors: Jan
authors: J
authors: Karlsson
authors: Anna-Karin
authors: AK
authors: Lindroos
authors: Hans
authors: H
authors: Lönroth
authors: Ingmar
authors: I
authors: Näslund
authors: Torsten
authors: T
authors: Olbers
authors: Kaj
authors: K
authors: Stenlöf
authors: Jarl
authors: J
authors: Torgerson
authors: Göran
authors: G
authors: Agren
authors: Lena M S
authors: LM
authors: Carlsson
mesh_terms: D050110:Bariatric Surgery; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000401:mortality* / Q000601:surgery*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D015431:Weight Loss