Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: The SOS Intervention Study

Objective: To examine the effect of a large, long standing and intentional weight reduction on the incidence of diabetes, hypertension and lipid distu rbances in severely obese individuals as compared to weight-stable obese co ntrols. Research Methods and Procedures: The ongoing prospective SOS (Swedish Obese Subjects) intervention consists of a surgically treated group and a matche d control group obtaining conventional obesity treatment. This report is ba sed on 845 surgically treated patients and 845 controls (BMI41.0+/-4.6 kg/m (2) (mean+/-standard deviation [S])) followed for 2 years. Results: Surgically treated patients lost 28+/-15 kg and controls 0.5+/-8.9 kg (p<0.0001). Two-year incidence of hypertension, diabetes, hyperinsuline mia, and lipid disturbances was compared in the two treatment groups. Adjus ted odds ratios (95% CI) for the surgically treated group versus controls w ere 0.38 (0.22, 0.65) for hypertension, 0.02 (0.00, 0.16) for diabetes, 0.1 0 (0.03, 0.28) for hyperinsulinemia, 0.10 (0.04, 0.25) for hypertriglycerid emia, 0.28 (0.16, 0.49) for low HDL-cholesterol and 1.24 (0.84, 1.8) for hy percholesterolemia. Compared to controls, the 2-year recovery rates from hy pertension, diabetes, hypo-HDL, and hypertriglyceridemia were significantly higher in the surgically treated group. Discussion: Intentional weight loss in the obese causes a marked reduction in the 2-year incidence of hypertension, diabetes and some lipid disturbanc es. The results suggest that severe obesity can and should be treated.