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

• Published in: The New England journal of medicine Vol. 351; no. 26; pp. 2683 - 2693
• Main Authors: Sjöström, Lars, Sjöström, Carl David, Lindroos, Anna-Karin, Peltonen, Markku, Torgerson, Jarl, Bouchard, Claude, Carlsson, Björn, Dahlgren, Sven, Larsson, Bo, Narbro, Kristina, Sullivan, Marianne, Wedel, Hans
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 23.12.2004
• Subjects: Biological and medical sciences; blood; Body Mass Index; complications; Diabetes Mellitus; Diabetes Mellitus - epidemiology; Diabetes Mellitus - etiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Energy Intake; epidemiology; etiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercise; Female; Follow-Up Studies; Gastric Bypass; Gastroplasty; General aspects; Humans; Hyperlipidemias; Hyperlipidemias - epidemiology; Hyperlipidemias - etiology; Hypertension; Hypertension - epidemiology; Hypertension - etiology; Hyperuricemia; Hyperuricemia - epidemiology; Hyperuricemia - etiology; Incidence; Insulin resistance; Life Style; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Mortality; Obesity; Obesity - blood; Obesity - complications; Obesity - mortality; Obesity - surgery; Risk Factors; Surgery; Treatment Outcome; Weight control; Weight Loss; Sweden; Endocrinopathy; Vascular disease; Medicine; Diabetes mellitus; Atherosclerosis; Risk factor; Bariatric surgery; Cardiovascular risk; Cardiovascular disease; Epidemiology; Life style
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa035622

The Swedish Obese Subjects Study followed obese subjects treated with gastric surgery and contemporaneously matched, conventionally treated obese controls. Surgically treated subjects who were enrolled for at least 2 years (4047 subjects) or 10 years (1703 subjects) had a lower incidence of diabetes, hypertriglyceridemia, and hyperuricemia; differences in the incidence of hypercholesterolemia and hypertension were not significant. Bariatric surgery appears to be a viable option in the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and amelioration of some risk factors. Obesity is associated with increased morbidity and mortality. 1 The increased morbidity is assumed to be mediated mainly by insulin resistance, diabetes, hypertension, and lipid disturbances — conditions that affect one quarter of the North American population. 2 , 3 Over the short term (one to three years), lifestyle changes resulting in weight loss result in improvements in insulin resistance, 4 diabetes, 5 – 7 hypertension, 8 and lipid disturbances 9 – 11 or in the prevention of these conditions. In contrast, several (but not all 12 ) observational epidemiologic studies have suggested that weight loss is associated with increased overall mortality and mortality from cardiovascular causes, not only among . . .