It has been well established that bariatric surgery is perhaps the most effective means of reducing both body weight and comorbid conditions associated with obesity. It clearly has a greater impact than any lifestyle changes. But not all types of bariatric surgery are equally effective, nor are the effects necessarily permanent. A new study examines these parameters with respect to laparoscopic sleeve gastrectomy (LSG).
Sleeve gastrectomy is a type of bariatric surgery in which as much as 75 percent of the stomach is removed, thus reducing its capacity to hold food. It is usually performed laparoscopically, and cannot be reversed. A new study, just published in JAMA Surgery, examines the results of this surgery with respect to weight loss and positive changes in several metabolic characteristics at 1, 3, and 5 years after surgery.
Inbal Golomb and colleagues from Bellinson Hospital in Petah Tikva, Israel. examined data from 443 patients who underwent LSG between 2006 and 2013; the surgery on all the patients was performed by the same team of surgeons. Compared to initial levels, the researchers found that one year after surgery, patients had complete remission of type 2 diabetes (51 percent), hypertension (46 percent), hypercholesterolemia (40 percent), and hypertriglyceridemia (72 percent). However, by 5 years following surgery, these remission rates were 20, 46, 26, and 72 percent respectively. Many of the patients with type 2 diabetes (65 percent at one year and 56 percent by 5 years post surgery) were able to stop using medications for the disease. Similarly, the effect of LSG on body weight waned over time. Initially, the average body weight was 262 lb; at 1, 3 and 5 years post surgery it was 180, 185 and 196 lb respectively. In their summary the authors stated that LSG indeed induced weight loss and a major improvement in obesity-related comorbidities. However, they acknowledged that there was significant weight regain and decreased remission rate of diabetes over time.
ACSH senior nutrition fellow Dr. Ruth Kava commented While these results may seem to be somewhat discouraging, it is still the case that a substantial amount of weight loss was maintained, and a fair percentage of patients did maintain at least some of the benefits of the surgical procedure. Further, it must be noted that many patients were lost to follow up of the over 400 patients who had LSG, only 38 were still available for evaluation five years after the procedure. Thus, more data from a larger group of patients would help in evaluating the longer term success of this particular surgical procedure.
