Weight-loss surgery prevents heart attacks and strokes in formerly obese people and reduces the risk of dying from cardiovascular complications, a study found.
Previous research had failed to prove that losing weight with diet and exercise lowered heart risks. Today’s report, one of the first to track the fate of patients who undergo surgery, found that sustaining a lower body weight was more important than the amount lost, the researchers said.
The study, reported in the Journal of the American Medical Association, didn’t find a higher benefit among those who lost more, suggesting the current guidelines that use weight to determine who is eligible for the operation may be misplaced.
“There are many benefits to bariatric surgery,” the researchers, led by Lars Sjostrom, from the University of Gothenburg’s Institutes of Medicine in Sweden, wrote. “Some of these benefits are independent of the degree of the surgically induced weight loss.”
The research tracked 4,047 Swedish patients for about 15 years. An earlier analysis of the data found that bariatric surgery improved quality of life and reduced the risk of diabetes, cancer and overall mortality.
Twenty-eight of the 2,010 patients who underwent surgery died from cardiovascular complications, compared with 49 of the 2,037 study participants who received standard medical care. There were 199 heart attacks and strokes among the surgery patients, compared with 234 in the other group.
Those who underwent bariatric surgery lost about 23 percent of their body weight within two years, and still weighed 18 percent less two decades later, according to the researchers. The weight in the comparison group was stable throughout the study.
The total difference in heart attacks, strokes and cardiovascular death between the groups is small, wrote Edward Livingston, from the University of Texas Southwestern Medical Center’s division of gastrointestinal and endocrine surgery, in an editorial. The expected benefits may not outweigh the risks of surgery and obese people shouldn’t have bariatric surgery unless they have other weight-related complications, he said.
The Swedish Medical Research Council and pharmaceutical companies including Johnson & Johnson, Sanofi, AstraZeneca Plc and Roche Holding AG helped fund the research.