Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study

Abstract

Obesity is associated with increased morbidity and mortality. Intentional weight loss results in improvement of cardiovascular risk factors, but most observational studies suggest that weight reduction is associated with increased overall and cardiovascular mortality. No prospective intervention studies on mortality have earlier been reported in obese subjects. The prospective, controlled Swedish Obese Subjects Study enrolled obese subjects who either underwent bariatric surgery (n ¼ 2010) or were allocated to a contemporaneously matched, conventionally treated obese control group (n ¼ 2037). This review sums up effects on morbidity and mortality over an average of 10 years. The mean weight change of the control group was less than ± 2% over up to 15 years of weight recording. Maximum weight losses in the surgical subgroups were observed after 1-2 years. After 10 years, the weight losses from baseline were stabilized at 25, 16 and 14%, respectively. Bariatric surgery improved all traditional cardiovascular risk states except hypercholesterolemia over 10 years. There were 129 deaths in the control group compared with 101 in the surgery group. The unadjusted overall mortality was reduced by 23.7% (P ¼ 0.0419) in the surgery group (relative to controls), whereas the gender-, age-and risk factor-adjusted mortality reduction was 30.7% (P ¼ 0.0102). The most common causes of death were myocardial infarction (controls n ¼ 25, surgery n ¼ 13) and cancer (47/29). Bariatric surgery for severe obesity is associated with long-term weight loss, improved risk factors and decreased overall mortality.

Obesity, diabetes mellitus and last but not least, osteoporosis

“…Weight loss evolves rapidly, and currently bariatric surgery has increasingly become recognized as a highly effective alternative for achieving major weight reduction for obese patients. A large prospective cohort study [Swedish Obese Subjects (SOS) study] found that weight loss was still apparent 10 years following surgery, whereas patients receiving conventional treatment had gained weight (22).…”

Vasoreactivity is rapidly improved in obese subjects after gastric bypass surgery

“…1 Weight loss regimens, including pharmacological treatments, are most often not efficacious in the long run, whereas gastric bypass (GBP) surgery is associated with a pronounced weight loss that is maintained over long time periods. 2 During the last two decades, much attention has been paid to the function of the endothelium, 3 in particular as endothelial dysfunction has been shown to predict cardiovascular events.…”

Bariatrik Cerrahi Sonrası Gelişen Nütrisyonel Polinöropati: Alışılmış Bir Klinikle Ortaya Çıkan Nadir Bir Olgu

“…The large Swedish obese subjects study reported mortality of 0.25% in the surgical cohort (5/2010 patients within 90 days of surgery) (2). Major adverse events following surgery include anastomotic leakage, pneumonia, pulmonary embolism, band slippage and band erosion (5).…”

“…Seven randomized controlled trials (RCTs) have reported an average reduction of 20% to 32% in initial body weight (depending on surgery technique) after 1-2 years of surgery (1). The Swedish Obese Subjects study (2) clearly showed that weight loss following surgery sustained 10 years post-surgery, whereas non-surgical treatment modalities did not result in long-term weight loss. Despite high percentages of weight loss, bariatric surgeries have been shown to result in many adverse events including neuropathies (3,4).…”