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

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 . . .