Weight-Loss Surgery Has Other Benefits: Easing Diabetes and Heart Disease

Bariatric surgery may substantially lower the risk of heart attacks, strokes and other major forms of cardiovascular disease, in addition to helping patients lose weight, according to new research published Monday in the Journal of the American Medical Association.

Analyzing the electronic health records over eight years of 13,722 obese patients with Type 2 diabetes and other high-risk health problems, researchers at the Cleveland Clinic found that those who had bariatric surgery—also known as metabolic or weight-loss surgery—were 39% less likely to experience a heart- or stroke-related event than those who had standard medical care. The surgery patients were also 41% less likely to die from any cause. Those effects were huge, said Ali Aminian, a bariatric surgeon at the Cleveland Clinic and lead author. The study was observational, he cautioned, meaning that it showed an association, but not that the surgery caused the effects. “The findings need to be tested in a randomized clinical trial,” Dr. Aminian said.

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The findings offer a potential path for patients whose diabetes and heart conditions aren’t helped by other means, said Steven Nissen, chief academic officer of the Heart and Vascular Institute at the Cleveland Clinic and senior author of the new study. Intensive lifestyle interventions didn’t help overweight or obese adults with diabetes reduce their risk of heart disease, in a large study funded by the National Institutes of Health published in 2013. “I was terribly discouraged when that paper came out,” Dr. Nissen said. “This is a very different result.”

Bariatric surgery is generally recommended for patients who are 100 pounds or more over their ideal weight; have a body-mass index of 40, or a BMI of 35 along with diabetes, high blood pressure or other related condition; and can’t lose weight and improve their health by other means. Patients with lower BMIs also get the surgery under some circumstances. Body-mass index is a calculation based on height and weight... Bariatric surgery isn’t a cure-all. It has risks, though improved techniques have made the procedures safer, Dr. Aminian said. It is also expensive, costing as much as $30,000, and not always covered by insurance.

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https://www.wsj.com/articles/weight-loss-surgery-has-other-benefits-easing-diabetes-and-heart-disease-11567405800 (paid subscription)