Bariatric surgery linked with reduced risk of coronary artery disease, stroke and death

People with severe obesity and type 2 diabetes who underwent bariatric (weight loss) surgery were around 40% less likely to suffer either a coronary artery event (such as a heart attack) or a stroke within five years than those who received standard diabetes care.
Patients who underwent bariatric surgery were over 70% less likely to die from any cause, implying a significant survival benefit of the surgery over standard care.
Various forms of bariatric surgery were used in the study: 71% of the patients receiving bariatric surgery underwent a Roux-en-Y gastric bypass, 17% underwent sleeve gastrectomy and 7% had an adjustable gastric band fitted.
The research was conducted in the USA by Kaiser Permanente, a healthcare provider, in Washingto, North Carolina and South Carolina, and by HealthPartners Institute in Minnesota. It builds upon previous research from the same group that found long-term diabetes remission in around half of gastric bypass patients and around half the risk of small blood vessel diseases for bariatric surgery patients overall.
It is estimated that over 3.4 million people in the UK have type 2 diabetes and many of them are also obese. Complications of diabetes can have a significant impact on lifespan and quality of life, and so bariatric surgery may be of use for improving the lives of some people with obesity and type 2 diabetes.
While some people may benefit from bariatric surgery for weight loss, this is an extreme and, with the exception of gastric banding, irreversible measure that the NHS does not perform lightly. Therefore, the surgery is only to be done once the potential risks and benefits to each patient have been thoroughly considered.
David Arterbur, MD, MPH, one of the authors of the study said “For most people with diabetes and severe obesity, lifestyle changes and medication may not be successful at significantly lowering those risks.
“So we’re excited about our results, which suggest that bariatric surgery may reduce new cases of heart attack and stroke, and risk of death from all causes.”
It is worth noting that the study’s data is observational, meaning that the bariatric surgery cannot be definitely held responsible for all of the results.
The main author of the study, Dr David Fisher, MD who is himself a bariatric surgeo, said “Ideally, randomized clinical trials would confirm or refute our findings. But such trials are expensive and difficult to conduct, and they probably couldn’t be done with enough patients to assess these relatively rare outcomes.”
The results of this study are published in JAMA.
For many people, lifestyle changes may instead be a preferable option to drugs and/or surgery. The results of our own Low Carb Program show that a quarter of users with type 2 diabetes are able to put their diabetes into remission and achieve an average weight loss of 7.4kg (1st, 2 lbs) at one year.