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 25 May 2018

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Bariatric surgery vs medical obesity treatment and long-term complications

The Journal of the American Medical Association compares bariatric surgery with medical obesity treatment and examines the association with long-term medical complications and obesity-related comorbidities.

News image

The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.

Dr Gunn Signe Jakobsen and colleagues compared changes in obesity-related comorbidities in patients with severe obesity undergoing bariatric surgery or specialized medical treatment.

The researchers performed a cohort study with baseline data of exposures from 2005 through 2010 and follow-up data from 2006 until death or through 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway.

Consecutive treatment-seeking adult patients with severe obesity were assessed.

The researchers compared bariatric surgery or specialized medical treatment including individual or group-based lifestyle intervention programs.

The proportion of patients with low ferritin levels was greater in the surgical group
Journal of the American Medical Association

The team's primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database.

Prespecified secondary outcomes included changes in comorbidities.

Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database.

Among 1888 patients included in the study, the mean age was 44 years.

The researchers found that surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension.

The team observed that surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure.

The proportion of patients with low ferritin levels was significantly greater in the surgical group.

Dr Jakobsen's team concludes, "Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities."

"The risk for complications should be considered in the decision-making process."

JAMA 2018;319(3):291-301
24 January 2018

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