Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. Effects of bariatric surgery on inflammatory, functional and structural markers of coronary atherosclerosis. Bariatric surgery and long-term cardiovascular events. Evaluation of Current Eligibility Criteria for Bariatric Surgery Three years durability of the improvements in health-related quality of life observed after gastric banding. Change in Predicted 10-Year Cardiovascular Risk Following Laparoscopic Roux-en-Y Gastric Bypass Surgery National Surgical Quality Improvement Program analysis of bariatric operations: modifiable risk factors contribute to bariatric surgical adverse outcomes. The effects of supervised exercise training 12–24 months after bariatric surgery on physical function and body composition: a randomised controlled trial Preoperative lifestyle intervention in bariatric surgery: a randomized clinical trial. Improved memory function two years after bariatric surgery. A bariatric surgery center of excellence: operative trends and long-term outcomes. Employment Outcomes One Year after Bariatric Surgery: the Role of Patient and Psychosocial Factors Optimizing long-term weight control after bariatric surgery: a pilot study. Is obesity a predictor of mortality, morbidity and readmission after cardiac surgery? Effects of bariatric surgery on mortality in Swedish obese subjects. Lipid profile changes in patients undergoing bariatric surgery: a comparative study between sleeve gastrectomy and mini-gastric bypass. Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study.
BACKGROUND Weight loss is associated with short-term amelioration and prevention of metabolic and cardiovascular risk , but whether these benefits persist over time is unknown . METHODS The prospect i ve , controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched , conventionally treated obese control subjects . We now report follow-up data for subjects ( mean age , 48 years ; mean body-mass index , 41 ) who had been enrolled for at least 2 years ( 4047 subjects ) or 10 years ( 1703 subjects ) before the analysis ( January 1 , 2004 ) . The follow-up rate for laboratory examinations was 86.6 percent at 2 years and 74.5 percent at 10 years . RESULTS After two years , the weight had increased by 0.1 percent in the control group and had decreased by 23.4 percent in the surgery group ( P<0.001 ) . After 10 years , the weight had increased by 1.6 percent and decreased by 16.1 percent , respectively ( P<0.001 ) . Energy intake was lower and the proportion of physically active subjects higher in the surgery group than in the control group throughout the observation period . Two- and 10-year rates of recovery from diabetes , hypertriglyceridemia , low levels of high-density lipoprotein cholesterol , hypertension , and hyperuricemia were more favorable in the surgery group than in the control group , whereas recovery from hypercholesterolemia did not differ between the groups . The surgery group had lower 2- and 10-year incidence rates of diabetes , hypertriglyceridemia , and hyperuricemia than the control group ; differences between the groups in the incidence of hypercholesterolemia and hypertension were undetectable . CONCLUSIONS As compared with conventional therapy , bariatric surgery appears to be a viable option for the treatment of severe obesity , result ing in long-term weight loss , improved lifestyle , and , except for hypercholesterolemia , amelioration in risk factors that were elevated at baseline This study was design ed to assess the effects of bariatric weight loss surgery on structural , functional , and inflammatory markers of coronary atherosclerosis . Obesity is a worldwide epidemic and an independent risk factor for coronary atherosclerosis . It remains unclear whether surgically induced weight loss reduces cardiovascular risk . This prospect i ve study enrolled 50 consecutive subjects with morbid obesity who underwent Roux-en-Y gastric bypass surgery ( GBS ) after failed attempts at medical weight loss . Subjects were recruited through a comprehensive weight loss center affiliated with an academic tertiary care hospital . All subjects had body mass indexes > or = 40 kg/m(2 ) or body mass indexes of 35 to 40 kg/m(2 ) with > or = 2 co-morbid obesity-related conditions . Markers of coronary atherosclerosis , including brachial artery flow-mediated dilation , carotid intima-media thickness , and high-sensitivity C-reactive protein , were measured before GBS and 6 , 12 , and 24 months after GBS . There were statistically significant improvements in all measured markers of coronary atherosclerosis after GBS . The mean body mass index decreased from 47 to 29.5 kg/m(2 ) at 24 months ( p < 0.001 ) , the mean carotid intima-media thickness regressed from 0.84 to 0.50 mm at 24 months ( p < 0.001 ) , mean flow-mediated dilation improved from 6.0 % to 14.9 % at 24 months ( p < 0.05 ) , and mean high-sensitivity C-reactive protein decreased from 1.23 to 0.65 mg/dl at 6 months ( p < 0.001 ) and to 0.35 mg/dl at 24 months ( p < 0.001 ) . In conclusion , GBS results in significant improvements in inflammatory , structural , and functional markers of coronary atherosclerosis CONTEXT Obesity is a risk factor for cardiovascular events . Weight loss might protect against cardiovascular events , but solid evidence is lacking . OBJECTIVE To study the association between bariatric surgery , weight loss , and cardiovascular events . DESIGN , SETTING , AND PARTICIPANTS The Swedish Obese Subjects ( SOS ) study is an ongoing , nonr and omized , prospect i ve , controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden of 2010 obese participants who underwent bariatric surgery and 2037 contemporaneously matched obese controls who received usual care . Patients were recruited between September 1 , 1987 , and January 31 , 2001 . Date of analysis was December 31 , 2009 , with median follow-up of 14.7 years ( range , 0 - 20 years ) . Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women . Exclusion criteria were identical in surgery and control patients . Surgery patients underwent gastric bypass ( 13.2 % ) , b and ing ( 18.7 % ) , or vertical b and ed gastroplasty ( 68.1 % ) , and controls received usual care in the Swedish primary health care system . Physical and biochemical examinations and data base cross-checks were undertaken at preplanned intervals . MAIN OUTCOME MEASURES The primary end point of the SOS study ( total mortality ) was published in 2007 . Myocardial infa rct ion and stroke were predefined secondary end points , considered separately and combined . RESULTS Bariatric surgery was associated with a reduced number of cardiovascular deaths ( 28 events among 2010 patients in the surgery group vs 49 events among 2037 patients in the control group ; adjusted hazard ratio [ HR ] , 0.47 ; 95 % CI , 0.29 - 0.76 ; P = .002 ) . The number of total first time ( fatal or nonfatal ) cardiovascular events ( myocardial infa rct ion or stroke , whichever came first ) was lower in the surgery group ( 199 events among 2010 patients ) than in the control group ( 234 events among 2037 patients ; adjusted HR , 0.67 ; 95 % CI , 0.54 - 0.83 ; P < .001 ) . CONCLUSION Compared with usual care , bariatric surgery was associated with reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults OBJECTIVE Patients with a BMI < 35 kg/m2 and patients with a BMI between 35 and 40 kg/m2 without comorbidities are noneligible by current eligibility criteria for bariatric surgery .  We used Swedish obese subjects ( SOS ) to explore long-term outcomes in noneligible versus eligible patients . RESEARCH DESIGN AND METHODS The SOS study involved 2,010 obese patients who underwent bariatric surgery ( 68 % vertical-b and ed gastroplasty , 19 % b and ing , and 13 % gastric bypass ) and 2,037 contemporaneously matched obese controls receiving usual care .  At inclusion , the participant age was 37–60 years and BMI was ≥34 kg/m2 in men and ≥38 kg/m2 in women . The effect of surgery was assessed in patients that do ( n = 3,814 ) and do not ( n = 233 ) meet current eligibility criteria . The date of analysis was 1 January 2012 . The follow-up time was up to 20 years , with a median of 10 years . RESULTS Cardiovascular risk factors were significantly improved both in noneligible and eligible individuals after 10 years of follow-up . Surgery reduced the diabetes incidence in both the noneligible ( adjusted hazard ratio 0.33 [ 95 % CI 0.13–0.82 ] , P = 0.017 ) and eligible ( 0.27 [ 0.22–0.33 ] , P < 0.001 ) groups . We could not detect a difference in the effect of surgery between the groups ( adjusted interaction P value = 0.713 ) . CONCLUSIONS Bariatric surgery drastically reduced the incidence of type 2 diabetes both in noneligible and eligible patients and improved cardiovascular risk factors in both groups . Our results show that strict BMI cutoffs are of limited use for bariatric surgery prioritization if the aim is to prevent diabetes and improve cardiovascular risk factors BACKGROUND Improvements in health-related quality of life ( HR-QoL ) occur after  bariatric surgery .  However , sustainability of these changes over time remains debated . METHODS Data collected in a prospect i ve 3-year multicenter Italian study on changes of HR-QoL after laparoscopic adjustable gastric b and ing were used .  HR-QoL has investigated with the SF-36 question naire .  Hunger , satiety , and the self-perceived effects of LAGB were recorded . RESULTS A total of 230 patients ( 53 male and 177 female ) were analyzed . Body mass index was 41.4±5.4 kg/m2 at baseline , declined to 33.8±5.8 kg/m2 12 months after surgery ( P<.001 ) , and further reduced to 31.9±5.1 kg/m2 36 months after surgery ( P<.001 versus 12 months ) . Scores in the SF-36 subscales were lower than in the general Italian population at baseline . The physical component summary score was 51.9±11.6 at baseline , improved to 79.2±15.4 at 12 months ( P<.001 ) , and stabilized to 79.8±15.6 at 36 months . The mental summary score was 52.3±11.8 at baseline , improved to 75.2±17.3 at 12 months ( P<.001 ) , and stabilized to 74.2±17.5 at 36 months . A decline>10 points between 12 and 36 months in the summary scores was observed in 22.0 % of the patients for PCS and in 26.8 % for MCS . In a multiple linear regression analysis , deterioration in HR-QoL in the 12 - 36 months period was associated to the presence of better HR-QoL values at 12 months and to a more pronounced reduction of the self-perceived effect of the b and ing at 36 months . CONCLUSION Improvements in HR-QoL observed in the first year after surgery maintained up to the third year after gastric b and ing Background Bariatric surgery is being conducted more often for morbid obesity , but little evidence exists about how it affects the risk of future cardiovascular events . The goal of this study was to quantify the change in predicted 10-year cardiovascular risk following  laparoscopic Roux-en-Y gastric bypass ( LRYGBP ) .  Methods We conducted a prospect i ve clinical study of morbidly obese adults undergoing LRYGBP at a university hospital in the USA . Our primary outcome measure was mean change in 10-year cardiovascular risk at 12 months . We estimated cardiovascular risk by using the Framingham risk equation , which calculates the absolute risk of cardiovascular events for patients with no known history of heart disease , stroke , or peripheral vascular disease by using information on age , sex , blood pressure , total and high-density lipoprotein cholesterol levels , smoking status , and history of diabetes . Results Ninety-two participants underwent LRYGBP between December 2004 and October 2005 . Their predicted baseline 10-year cardiovascular risk was 6.7 % . At 6 and 12 months , their predicted risk had decreased to 5.2 % and 5.4 % , respectively . Assuming no change in risk among untreated patients , this represents an absolute risk reduction of 1.3 % ; which suggests that 77 morbidly obese patients would have to undergo LRYGBP  to avert one new case of cardiovascular disease over the ensuing 10 years ( number needed to treat = 77 ) . Conclusion Our findings indicate that LRYGBP is associated with improvements in cardiovascular risk factors and a corresponding decrease in predicted 10-year risk of cardiovascular disease BACKGROUND The increase in obesity coupled with greater acceptance of the field of bariatric surgery has result ed in a substantial rise in the number of weight-loss operations . Because obese individuals are at high risk for surgical complications , concern about the safety of bariatric procedures exists . Earlier investigations of the clinical features associated with surgical complications have produced conflicting results . We sought to identify risk factors for surgical complications in a large , nationally representative population of US veterans . STUDY DESIGN We analyzed data  on bariatric procedures performed at 12 Veterans ' Affairs medical centers approved to perform weight-loss operations between 1998 and 2004 . Detailed pre- , intra- , and postoperative information and longterm mortality data were prospect ively collected using the National Surgical Quality Improvement Program methodology . We used multivariable logistic regression to identify clinical features associated with postoperative complications . RESULTS Among 575 bariatric patients assessed between 1998 and 2004 , 74 % were men with a mean age of 51 years . Thirty-day mortality was 1.4 % . Overall complication rate was 19.7 % . Of those with complications , one-half were of considerable clinical importance , as they were associated with prolonged length of stay . Clinical features that were predictive of adverse events in our multivariable analyses were superobesity , weight>350 pounds , and smoking . A more than 20 pack-year history of smoking was also associated with difficulty in weaning from a ventilator postoperatively . CONCLUSIONS We identified smoking and superobesity as preoperative risk factors associated with postoperative complications . Future studies should examine the effect of preoperative weight loss and smoking cessation on bariatric procedure outcomes Background : Bariatric surgery is effective for the treatment of stage II and III obesity and its related diseases , although increasing evidence is showing weight regain ~12–24 months postsurgery . Weight regain increases the risk of physical function decline , which negatively affects an individual 's ability to undertake activities of daily living . The study assessed the effects of a 12-week supervised exercise intervention on physical function and body composition in patients between 12 and 24 months post bariatric surgery . Methods : Twenty-four inactive adult bariatric surgery patients whose body mass index remained ⩾30 kg m2 12 to 24 months post surgery were r and omised to an exercise intervention ( n=12 ) or control group ( n=12 ) . Supervised exercise consisted of three 60-min gym sessions per week of moderate intensity aerobic and resistance training for 12 weeks . Control participants received usual care .  The incremental shuttle walk test ( ISWT ) was used to assess functional walking performance after the 12-week exercise intervention , and at 24 weeks follow-up . Measures of anthropometric , physical activity , cardiovascular and psychological outcomes were also examined . Using an intention-to-treat protocol , independent t-tests were used to compare outcome measures between groups . Results : Significant improvements in the exercise group were observed for the ISWT , body composition , physical function , cardiovascular and self-efficacy measures from baseline to 12 weeks . A large baseline to 12-week change was observed for the ISWT ( exercise : 325.00±117.28 m ; control : 355.00±80.62 m , P<0.001 ) . The exercise group at 24 weeks recorded an overall mean improvement of 143.3±86.6 m and the control group recorded a reduction of −32.50±75.93 m. Findings show a 5.6 kg difference between groups in body mass change from baseline to 24 weeks favouring the exercise group . Conclusions : A 12-week supervised exercise intervention led to significant improvements in body mass and functional walking ability post intervention , with further improvements at the 24-week follow-up BACKGROUND Studies on the impact of presurgery weight loss and lifestyle preparation on outcomes following bariatric surgery are needed . OBJECTIVE To evaluate whether a presurgery behavioral lifestyle intervention improves weight loss through a 24-month postsurgery period . SETTING Bariatric Center of Excellence at a large , urban medical center . METHODS C and i date s for bariatric surgery were r and omized to a 6-month behavioral lifestyle intervention or to 6 months of usual presurgical care . The lifestyle intervention consisted of 8 weekly face-to-face sessions , followed by 16 weeks of face-to-face and telephone sessions before surgery ; the intervention also included 3 monthly telephone contacts after surgery . Assessment s were conducted 6 , 12 , and 24 months after surgery . RESULTS Participants who underwent surgery ( n = 143 ) were 90.2 % female and 86.7 % White . Average age was 44.9 years , and average body mass index was 47.5 kg/m(2 ) at study enrollment . At follow-up , 131 ( 91.6 % ) , 126 ( 88.1 % ) , 117 ( 81.8 % ) patients participated in the 6- , 12- , and 24-month assessment s , respectively . Percent weight loss from study enrollment to 6 and 12 months after surgery was comparable for both groups , but at 24 months after surgery , the lifestyle group had significantly smaller percent weight loss compared with the usual care group ( 26.5 % versus 29.5 % , respectively , P = .02 ) . CONCLUSIONS Presurgery lifestyle intervention did not improve weight loss at 24 months after surgery . The findings from this study raise questions about the utility and timing of adjunctive lifestyle interventions for bariatric surgery patients OBJECTIVE Obesity is as an independent risk factor for poor neurocognitive outcomes , including Alzheimer 's disease .  Bariatric surgery has recently been shown to result in improved memory at 12-weeks postoperatively . However , the long-term effects of bariatric surgery on cognitive function remain unclear . DESIGN AND METHODS Eighty-six individuals ( 63 bariatric surgery patients , 23 obese controls ) were recruited from a prospect i ve study examining the neurocognitive effects of bariatric surgery .  All participants completed  self-report measurements and a computerized cognitive test battery  prior to surgery and at 12-week and 24-month follow-up ; obese controls completed measures at equivalent time points . RESULTS Bariatric surgery patients exhibited high rates of pre-operative cognitive impairments in attention , executive function , memory , and language . Relative to obese controls , repeated measures ANOVA showed improvements in memory from baseline to 12-weeks and 24-months postoperatively ( P < 0.05 ) . Regression analyses controlling for baseline factors revealed that a lower BMI at 24-months demonstrated a trend toward significance for improved memory ( β = -.30 , P = 0.075 ) . CONCLUSION These findings suggest that cognitive benefits of bariatric surgery may extend to 24-months postoperatively . Larger prospect i ve studies with extended follow-up periods are needed to eluci date whether bariatric surgery decreases risk for cognitive decline and possibly the development of dementia BACKGROUND Surgery remains the most effective intervention for obesity and its comorbidities . However , the long-term efficacy of bariatric procedures is rarely reported . This study addresses operative trends , efficiency , and long-term outcomes from a large bariatric program . STUDY DESIGN Data were prospect ively collected on 3,460 patients undergoing 3,503 operations from January 2004 to March 2013 . Primary procedures included  Roux-en-Y gastric bypass  ( RY ; n = 2,966 ) , adjustable b and ( AB ; n = 352 ) , and sleeve gastrectomy ( SG ; n = 118 ) . There were 67 revisional procedures ( RP ) . Mean operative time , hospital length of stay , major 30-day morbidity/mortality , follow-up compliance , and weight loss per procedure at follow-up were recorded . RESULTS Mean operative times decreased to the following : RY , 53 minutes ; AB , 35 minutes ; SG , 46 minutes ; and RP , 71 minutes . Mean length of stay was reduced to the following : RY , 1.53 days ; AB , 0.97 days ; SG , 2.12 days ; and RP , 2.68 days . Major complications were mortality , 0.09 % ; leak , 0.51 % ; bleed , 2.37 % ; pneumonia , 0.63 % ; venous thromboembolism , 0.40 % ; and reoperation , 2.34 % . The complication rate was lowest for AB and highest for SG ( p < 0.05 ) . Adjustable b and was the initial procedure in 73 % of cases requiring RP . Follow-up compliance was 93 % at 1 year , 79 % at 3 years , 71 % at 5 years , and 33 % at 9 years . Adjustable b and offered significant weight loss at 1 and 3 years ( p < 0.0001 ) , but less than RY or SG ( p < 0.0001 ) . Excess weight loss was not significantly different between RY and SG at 1 year . Significant weight loss with RY persisted at 7 to 9 years ( p < 0.0001 ) . CONCLUSIONS Our bariatric program experienced an increase in SG and RP and a decrease in AB . Optimization of care reduced operative time and length of stay . All procedures achieved significant weight loss in the first year . Adjusted b and had the lowest morbidity , but inferior weight loss and greater need for revision . Long-term weight-loss data are only available for RY Background Patients undergoing bariatric surgery  generally report improved work performance after this procedure ; however , previous research has been limited by a lack of st and ardized employment measures and a failure to account for the impact of psychiatric illness on employment outcomes . To address these limitations , this study aims to assess changes in patients ’ employment impairment and productivity 12 months post-surgery and to identify psychosocial predictors of change in employment outcomes . Methods A total of 164 patients underwent bariatric surgery between February 2010 and November 2012 in this prospect i ve cohort study . The primary outcome was a change in employment impairment ( EI ) as measured by total Lam Employment Absence and Productivity Scale ( LEAPS ) scores and changes in participants ’ job status category . Multiple linear regression models assessed whether baseline demographic or clinical factors , including a history of psychiatric illness and changes in depressive , anxiety and quality of life ( QOL ) symptoms , were associated with a change in LEAPS scores . Results Participants reported a significant reduction in EI post-surgery ( p < 0.0001 ) and improvement in work productivity ( p < 0.0001 ) 12 months after surgery . Only changes in depression ( confidence interval ( CI ) 0.46 , 0.76 , p < 0.0001 ) , anxiety ( CI 0.49 , 0.85 , p < 0.0001 ) and mental QOL ( CI −0.30 , −0.17 , p < 0.0001 ) were significant predictors of change in EI total scores . Logistic regression analysis did not identify significant predictors of change in participant job status . Conclusions Patients with pre-bariatric surgery psychiatric distress are more likely to report greater employment impairment and worse employment productivity pre-surgery . These patients also experience the greatest improvements in post-surgery employment functioning BACKGROUND Although bariatric surgery is associated with significant overall weight loss , many patients experience suboptimal outcomes . Our objective was to document the preliminary efficacy of a behavioral intervention for bariatric surgery patients with relatively poor long-term weight loss and to explore the factors related to outcome at an academic medical center in the United States . METHODS Patients with a body mass index ( BMI ) ≥ 30 kg/m(2 ) who had undergone bariatric surgery ≥ 3 years before study entry and had < 50 % excess weight loss were enrolled . The participants were r and omly assigned to a 6-month behavioral intervention or wait list control group . The assessment s were conducted at baseline ( before intervention ) and 6 months ( after intervention ) and 12 months ( 6-mo follow-up ) . RESULTS On average , the participants ( n = 36 ) had undergone surgery 6.6 years before study entry . The average age was 52.5 ± 7.1 years , and the BMI was 43.1 ± 6.2 kg/m(2 ) ; most participants were women ( 75 % ) and white ( 88.9 % ) . The intervention patients had a greater percentage of excess weight loss than did the wait list control group at 6 ( 6.6 % ± 3.4 % versus 1.6 % ± 3.1 % ) and 12 ( 5.8 % ± 3.5 % versus .9 % ± 3.2 % ) months . However , the differences were not significant and the results varied . The intervention patients with more depressive symptoms ( P = .005 ) and less weight regain before study entry ( P = .05 ) experienced a greater percentage of excess weight loss . CONCLUSION Behavioral intervention holds promise in optimizing long-term weight control after bariatric surgery . More research is needed on when to initiate the intervention and to identify which patients will benefit from this type of approach INTRODUCTION Obesity has been described as a risk factor for the development of coronary artery disease , but it has not been determined whether obesity is associated with adverse outcomes after cardiac surgery . Therefore , we analyzed a large cohort of patients who had undergone cardiac surgery to determine whether obesity is a predictor of mortality , morbidity or early readmission to hospital . METHODS At the London Health Sciences Centre , an academic tertiary care centre , we prospect ively entered data from the cardiac surgical data base from July 1999 to April 2002 . We collected data on 1310 consecutive , unselected patients who underwent cardiac surgery during that time . We assessed the degree of obesity using the body mass index ( BMI ) , and we prospect ively documented the occurrence of 10 major complications after surgery . They included stroke , reoperation for bleeding , life-threatening cardiac arrest or arrhythmia , new renal failure requiring dialysis , septicemia , mediastinitis , sternal dehiscence , respiratory failure , postoperative myocardial infa rct ion and low cardiac output necessitating intra-aortic balloon pump use . Univariable and multivariable analyses were conducted to determine the factors associated with and predictive of postoperative death and major complications . RESULTS An increased BMI did not increase the risk of early postoperative death . Furthermore , increased BMI was not a predictor of a patient experiencing any of the major complications , except sternal dehiscence . An increased BMI was associated with a higher likelihood of readmission to hospital within 30 days of discharge . CONCLUSION Obesity was not associated with adverse outcomes after cardiac operations , aside from the increased risks of sternal dehiscence and early hospital readmission BACKGROUND Obesity is associated with increased mortality . Weight loss improves cardiovascular risk factors , but no prospect i ve interventional studies have reported whether weight loss decreases overall mortality . In fact , many observational studies suggest that weight reduction is associated with increased mortality . METHODS The prospect i ve , controlled Swedish Obese Subjects study involved 4047 obese subjects . Of these subjects , 2010 underwent bariatric surgery ( surgery group ) and 2037 received conventional treatment ( matched control group ) .  We report on overall mortality during an average of 10.9 years of follow-up . At the time of the analysis ( November 1 , 2005 ) , vital status was known for all but three subjects ( follow-up rate , 99.9 % ) . RESULTS The average weight change in control subjects was less than + /-2 % during the period of up to 15 years during which weights were recorded . Maximum weight losses in the surgical subgroups were observed after 1 to 2 years : gastric bypass , 32 % ; vertical-b and ed gastroplasty , 25 % ; and b and ing , 20 % . After 10 years , the weight losses from baseline were stabilized at 25 % , 16 % , and 14 % , respectively . There were 129 deaths in the control group and 101 deaths in the surgery group . The unadjusted overall hazard ratio was 0.76 in the surgery group ( P=0.04 ) , as compared with the control group , and the hazard ratio adjusted for sex , age , and risk factors was 0.71 ( P=0.01 ) . The most common causes of death were myocardial infa rct ion ( control group , 25 subjects ; surgery group , 13 subjects ) and cancer ( control group , 47 ; surgery group , 29 ) . CONCLUSIONS Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality OBJECTIVE To prospect ively evaluate the effect of different types of bariatric surgery on lipid profile . METHODS  Total cholesterol ( TC ) , High-Density-Lipoprotein cholesterol ( HDLc ) , Low-Density-Lipoprotein cholesterol ( LDLc ) and triglycerides ( TG ) levels  were evaluated before surgery and at 3 different post-operative time-points ( 3 , 6 and 12 months ) in consecutive obese subjects undergoing mini-gastric bypass ( MGB ) or sleeve gastrectomy ( SG ) . RESULTS At baseline , 74 MGB and 86 SG subjects were comparable for lipid profile and prevalence of hypercholesterolemia/hypertriglyceridemia . During the post-operative follow-up , both MGB and SG subjects showed significant changes in lipid profile . However , at 3 months , MGB patients showed higher changes in TC ( β = 0.179 , p = 0.022 ) and TG ( β = 0.265 , p = 0.001 ) than those undergoing SG . At 6-month post-operative follow-up , these differences were confirmed only for TC . After a 12-month follow-up , MGB and SG were entirely comparable for changes in lipid profile with the exception of HDLc , whose changes were higher in SG group ( β = 0.130 , p = 0.039 ) . Overall , the probability to normalize lipid profile during the 12-month follow-up was similar in MGB and in SG patients ( OR:1.24 , 95%CI:0.41 - 3.76 , p = 0.689 ) . CONCLUSION Despites some differences at 3 - 6 post-operative months , during a 12-month follow-up , SG and MGB showed a similar efficacy in the improvement of lipid profile of obese patients BACKGROUND There is a lack of adequate prospect i ve data on quality -of-life ( QOL ) and its predictors in patients undergoing laparoscopic sleeve gastrectomy ( LSG ) .  The aim of this study was to assess longitudinal changes in QOL after LSG with the use of the obesity-specific Moorehead-Ardelt II question naire ( MAII ) and to identify clinical parameters associated with QOL outcome . METHODS Morbidly obese patients consecutively admitted for LSG , over a 30-month period , were prospect ively studied . QOL was assessed using the vali date d Greek version of the MAII question naire and a visual analogueue scale ( VAS ) , preoperatively and at 6 , 12 , and 24 months postoperatively . Anthropometric data and obesity-related co-morbidities were recorded . RESULTS A total of 111 patients with a mean age 36.8±9.2 years were included . Mean preoperative body mass index ( BMI ) was 49.1±7.5 kg/m2 . Percentage excess BMI loss ( % EBL ) was 51.1±14.9 , 64.2±17.9 and 66.4±18.0 at 6 , 12 , and 24 months , respectively . Postoperatively , all obesity-related co-morbidities were significantly improved . MAII score increased from -.40±1.30 preoperatively to 1.75±.83 , 2.18±.80 , and 1.95±.71 at 6 , 12 , and 24 months postoperatively ( trend P<.001 ) . Preoperative median ( interquartile range ) VAS was 3 ( 1 ) increasing to 9 ( 2 ) , 10 ( 1 ) , and 9 ( 1 ) at 6 , 12 , and 24 months postoperatively ( P<.001 ) . % EBL and reduction in obesity-related co-morbidities , especially resolution of diabetes and sleep apnea , correlated significantly with higher QOL during the course of the study . CONCLUSION LSG , a safe and effective bariatric operation , results in sustained weight loss and significant improvements in QOL . Both weight loss and amelioration of co-morbidities contribute to higher level of postsurgical QOL
Results from the meta-regression approach showed an inverse relation between cardiovascular risks and BMI reduction .
Conclusions The present study showed an overall reduction of cardiovascular risk after bariatric surgery .
In summary , our study showed that laparoscopic bariatric surgery is an effective therapeutic option to reduce the cardiovascular risk in severe obese patients
Background This study aims to evaluate the 12–24-month impact of bariatric surgery on the foremost modifiable traditional risk factors of cardiovascular disease .