medwireNews: A meta-analysis shows that bariatric or metabolic surgery significantly increases life expectancy compared to standard obesity care, with the largest increases being recorded in people with type 2 diabetes.
The overall risk of mortality with surgery was reduced by 49.2% compared to standard care, according to results published in The Lancet.
When divided into people with and without diabetes, the risk reduction in the former group was significantly greater (59.1%) than in people without diabetes (29.6%).
Asim Shabbir (National University Health System, Singapore) and study co-authors calculated a figure of 8.4 to prevent death over 10 years in people with type 2 diabetes and 5.3 to prevent death over 20 Years to prevent.
Again, the effect was less in people without diabetes, at 29.8 and 19.0 counts, to prevent death over 10 and 20 years, respectively.
And the same pattern was seen for the increase in life expectancy; Bariatric / metabolic surgery was associated with a median of an additional 9.3 years for people with diabetes and 5.1 years for people without diabetes.
The researchers included 17 studies in their meta-analysis that yielded patient-level data for 174,772 participants, of whom 7712 died during a mean follow-up of 69.4 months. They found no significant differences in survival benefit according to the surgical approach of Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding, which were associated with reductions in overall mortality risk of 57%, 52% and 50%, respectively.
In a related editorial, Geltrude Mingrone (University of Cattolica del Sacro Cuore, Rome, Italy) and Stefan Bornstein (King’s College London, UK) state that “only 1% of eligible individuals, for a number of reasons, including obesity stigma, do one Metabolic-bariatric surgery. ”
However, the researchers estimate that any 1% increase in the number of eligible people undergoing bariatric or metabolic surgery would result in an additional 5,133,600 future years of life for people with diabetes and 6,568,800 future years of life for people without diabetes .
Commentators add that it is currently unclear whether bariatric or metabolic surgery can reduce people’s life expectancy to that of the general population, or whether years of obesity have an irreversible impact, as implied in a previous study.
“The obvious implication is that prevention or early treatment of obesity is critical to avoiding organ damage,” say Mingrone and Bornstein.
They conclude: “Until obesity drugs can produce clinically meaningful and sustained weight loss, metabolic-bariatric surgery is a valuable tool to extend lifespan and reduce life-threatening obesity comorbidities.”
medwireNews is an independent medical news service from Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
Lancet 2021; doi: 10.1016 / S0140-6736 (21) 00591-2
Lancet 2021; doi: 10.1016 / S0140-6736 (21) 00952-1