Weight loss is associated with short-term amelioration and prevention of metabolic
and cardiovascular risk, but whether these benefits persist over time is unknown.
The prospective, controlled Swedish Obese Subjects Study involved obese subjects who
underwent gastric surgery and contemporaneously matched, conventionally treated obese
control subjects. We now report follow-up data for subjects (mean age, 48 years; mean
body-mass index, 41) who had been enrolled for at least 2 years (4047 subjects) or
10 years (1703 subjects) before the analysis (January 1, 2004). The follow-up rate
for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years.
After two years, the weight had increased by 0.1 percent in the control group and
had decreased by 23.4 percent in the surgery group (P<0.001). After 10 years, the
weight had increased by 1.6 percent and decreased by 16.1 percent, respectively (P<0.001).
Energy intake was lower and the proportion of physically active subjects higher in
the surgery group than in the control group throughout the observation period. Two-
and 10-year rates of recovery from diabetes, hypertriglyceridemia, low levels of high-density
lipoprotein cholesterol, hypertension, and hyperuricemia were more favorable in the
surgery group than in the control group, whereas recovery from hypercholesterolemia
did not differ between the groups. The surgery group had lower 2- and 10-year incidence
rates of diabetes, hypertriglyceridemia, and hyperuricemia than the control group;
differences between the groups in the incidence of hypercholesterolemia and hypertension
were undetectable.
As compared with conventional therapy, bariatric surgery appears to be a viable option
for the treatment of severe obesity, resulting in long-term weight loss, improved
lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that
were elevated at baseline.
Copyright 2004 Massachusetts Medical Society.