Bariatric surgery has become one of the most effective treatments for severely obese patients. The surgery promotes weight loss by changing the digestive system s anatomy, limiting the amount of food that can be consumed and digested. Now, a recent meta-analysis of 52 studies has found that, in addition to losing large amounts of weight, patients who underwent a particular type of bariatric surgery reduced their predicted risk of cardiovascular disease by almost one-half.
As they reported in the American Journal of Cardiology, doctors from the Cleveland Clinic culled studies from 1950 to 2010, ultimately analyzing a total of almost 17,000 patients who had a mean body mass index (BMI) of 49 prior to surgery (a BMI of over 25 is considered overweight; over 30 is obese, and over 40 is considered severely or morbidly obese). The average loss of excess weight was greater than 50 percent, and was associated with significant improvement in cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and other relevant biomarkers. The doctors determined that patients 10-year coronary heart disease risk initially averaged 6.3 percent and was 3.8 percent at the end of follow-up an impressive 40 percent improvement.
Overall, say the authors, their analysis provides substantive evidence to support surgical treatment of obesity in order to reduce the risk of cardiovascular disease. However, the surgery these patients underwent involves significant revision of the normal GI tract, a major procedure that can have significant side effects which some critics feel may outweigh any benefits it confers. The authors, in turn, point out that, while patients frequently have trouble adhering to a lifelong course of medication to reduce such risk factors, bariatric surgery is performed once and has immediate and lasting effects.
A 40 percent reduction in cardiovascular risk is a dramatic improvement, says ACSH's Dr. Gilbert Ross, who is impressed with the findings. Clearly, this is an invasive intervention, with serious potential for operative and post-operative complications, he notes. But the results appear to merit it in such severely obese patients.