Bariatric surgery is associated with long-term weight loss and health risk reductions

December 22, 2015

Bariatric surgery delivered in routine clinical practice in the UK is associated with a substantial initial weight loss that is sustained for at least four years after surgery, according to a study published this week in PLOS Medicine. The longitudinal study, conducted by Ian Douglas and colleagues at the London School of Hygiene & Tropical Medicine, UK, also shows that bariatric surgery is associated with improvements in pre-existing type 2 diabetes and hypertension and with a reduced risk of the onset of several obesity-related co-morbidities.

Bariatric surgery has helped obese people lose weight in randomized controlled trials, but the benefits for patients' broader health over a longer period have not been as well studied. Here, the researchers investigated whether there was an association between bariatric surgery and subsequent weight, BMI, and obesity-related illnesses in a study of 3882 bariatric surgery patients and similar control patients who did not have surgery, tracked using primary care records in the UK Clinical Practice Research Datalink. Bariatric surgery patients lost weight at a rate of 4.98 kg/month (95% Confidence Intervals 4.88 to 5.08) during the first four post-operative months (versus no change in the comparision group); their weight loss was sustained at a slower rate for four years. Bariatric surgery was also associated with a reduced risk of getting a new diagnosis of type 2 diabetes (Hazard Ratio with 95% CI: 0.68 (0.55-0.83)), hypertension (0.35 (0.27-0.45)), angina (0.59 (0.40-0.87)), heart attack (0.28 (0.10-0.74)), and obstructive sleep apnea (0.55 (0.40-0.87)). Surgery was also associated with increased resolution of both type 2 diabetes (9.29 (6.84 - 12.62)) and hypertension (5.64 (2.65-11.99) among people who already had these conditions. The investigators did not detect an association between bariatric surgery and reduced mortality in this study, but noted that longer follow-up may be needed to establish associations with mortality.

The accuracy of these findings may be limited by the incomplete recording of some outcomes in primary care patient management records. Nevertheless, these results suggest that widening the availability of bariatric surgery in the UK could provide substantial health benefits for people who are very obese. The authors estimate that, assuming these associations are causal, broader use of bariatric surgery in the UK over four years could prevent or resolve roughly 93,000 cases of hypertension and 149,000 cases of type 2 diabetes.
-end-
Research Article

Funding:

IJD is funded by a Medical Research Council Fellowship (G0802403/1). LS is funded by a Wellcome Trust Fellowship. RLB is funded by the Rosetrees Trust. KB holds a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (grant number 107731/Z/15/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

I have read the journal's policy and the authors of this manuscript have the following competing interests: RLB has consulted for GlaxoSmithKline and received honoraria from Ethicon and Pfizer.

Citation:

Douglas IJ, Bhaskaran K, Batterham RL, Smeeth L (2015) Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS Med 12(12): e1001925. doi:10.1371/journal.pmed.1001925

Author Affiliations:

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom

Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, United Kingdom

University College London Hospitals Bariatric Centre for Weight Management and Metabolic Surgery, London, United Kingdom

National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, United Kingdom

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001925

Contact:

Ian Douglas
London School of Hygiene & Tropical Medicine
Department of Epidemiology & Population Health
ian.douglas@lshtm.ac.uk

Press Office
London School of Hygiene & Tropical Medicine
Department of Epidemiology & Population Health
Keppel Street
London, WC1E 7HT
UNITED KINGDOM
+44(0)2079272802
press@lshtm.ac.uk

PLOS

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.