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The British Journal of Surgery

Obesity surgery linked to lower risks of complications and death

Five-year rates of major heart and blood vessel events were 6.1% after surgery versus 8.1% after starting medication in adults with obesity and type 2 diabetes.

Paper by Andrew P. Gillikin, Emily P. Rabinovich, Abdelrahman Ali Nimeri, Ali Tavakkoli, Thomas H. Shin · University of Virginia Health System
Graphical abstract from The British Journal of Surgery
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Graphical abstract. Gillikin et al.

Our read

Interventions
Studied:
Cohort study of 379,858 adults with obesity and diabetes, median 4.9 years (surgery)
What changed:
5-year risk of death from any cause was lower after surgery: 2.1% versus 3.7% after starting obesity medications
The catch:
Reported outcomes omit surgical complications, leaving surgery's immediate harms out of the comparison
In the record:
The 16th paper on metabolic bariatric surgery with results in people; 24 on record in all.
Why it’s aging research:
It studies an intervention with evidence of extending healthy life.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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An observational cohort study compared 379,858 adults aged 18 or older with obesity and type 2 diabetes who underwent metabolic bariatric surgery or started weight-management medication. Researchers used statistical weighting to balance the groups’ measured starting characteristics. Median follow-up was 4.9 years after surgery and 4.3 years after medication initiation.

Surgery was associated with lower five-year rates of kidney disease: 4.5% versus 8.3% after medication. Diabetes-related eye disease rates were 3.6% versus 7.4%. Major heart and blood vessel events occurred in 6.1% versus 8.1%, and death from any cause in 2.1% versus 3.7%. Average total weight loss at one year was 25.4% after surgery versus 6.4% after medication.

Why it matters

The comparison addresses how obesity care relates to long-term complications of type 2 diabetes, outcomes relevant to maintaining health in later life.

Caveats

This observational comparison cannot establish cause and effect, even after balancing measured characteristics. The findings concern adults with both obesity and type 2 diabetes; the abstract does not report surgical complications or medication side effects.

From the paper

Participants

In total, 379 858 adults met the inclusion criteria (32 401 underwent MBS and 347 457 initiated OMMs).

Results

Quoted word for word from the full text on academic.oup.com.

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