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New research finds that bariatric surgery can help significantly improve cardiometabolic health for people with obesity, including lowering high blood pressure and the risk of type 2 diabetes. Daniel Llao Calvet/Getty Images
  • Having bariatric surgery was linked with improvements in cardiometabolic health.
  • People who were young, female, or white or who did not yet have any other health conditions benefited most.
  • Bariatric surgery leads to reductions in the visceral fat that is linked with cardiometabolic disease.
  • It also reduces inflammation and improves hormone balance.
  • Those who haven’t yet developed obesity-related health conditions appear to be helped most by surgery.

New research published in the Journal of the Endocrine Society has found that bariatric surgery can create significant improvements in cardiometabolic health.

This was particularly true in those who were young, female, or white and in those without any other health conditions.

The study authors estimated that 10-year cardiovascular disease risk was reduced by 35% one year following the procedure.

Further, 30% to 50% of individuals had remission of diabetes, high blood pressure, and abnormal blood lipids.

Some common types of bariatric surgery include:

These surgeries are aimed at surgically modifying either the stomach or the intestines in order to limit how many calories people can eat or absorb. When done alongside diet and lifestyle changes, they allow people to experience long-term weight loss.

Bariatric surgeries are approved for adults with class III obesity. They must meet the criteria of either having a BMI of 40 or higher or a BMI of 35 with at least one obesity-related health condition.

The researchers noted that obesity, especially when it is severe, is strongly linked with diabetes, high blood pressure, abnormal lipids, and cardiovascular disease. Bariatric surgery is currently the most effective way to treat obesity and these associated health conditions.

However, they said information about which presurgical factors can predict these improvements is lacking, especially when it comes to Black patients. Their study sought to rectify this.

Altogether, 7,800 people between the ages of 20 and 79 who had had bariatric surgery between 1999-2022 at the Vanderbilt University Medical Center in Nashville, Tennessee, were included in the study.

While most patients were female and white, there were a significant number of men and Black patients.

The researchers assessed study participants’ blood pressure, cholesterol, and HbA1c (a test showing average blood sugar over the past few months) to see if there were any improvements in these measures following surgery.

They also checked to see how many people had remission from diabetes, high blood pressure, and high cholesterol.

The team additionally estimated the patients’ 10-year cardiovascular disease risk.

Those who were older, male, or Black had a smaller reduction in 10-year disease risk and lower odds of experiencing a remission of diabetes, high blood pressure, and abnormal cholesterol levels when compared to those who were younger, female, or white.

Those who had a history of diabetes, high blood pressure, and high cholesterol or cardiovascular disease had less improvement than those who did not.

Jessica Cutler, MD, a bariatric surgeon at The Maryland Bariatric Center at Mercy, located in Baltimore, Maryland, explained that the improvements seen after weight loss surgery likely have to do with the reduction in visceral fat, the type of fat buried deep inside the abdomen that surrounds our organs and intermingles with them.

“This type of fat is correlated very strongly with certain diseases like diabetes, heart disease, and high blood pressure,” she stated.

“It makes sense that improvement in this measurement after surgery would also lead to improvement in these conditions.”

However, Cutler noted that the effects seen in the study didn’t seem to be entirely dependent on how much weight people lost or maintained.

“[I]t may be that the improvements in inflammation and hormone balance after bariatric surgery lead to improved health even outside of weight loss,” she remarked.

Neil Floch, MD, a bariatric surgeon and the director of Bariatric Surgery for Greenwich Hospital in Greenwich, Connecticut, said that it’s already known that bariatric surgery increases blood levels of intestinal hormones such as GLP-1, GIP, and PYY, — the same hormones that are increasingly being targeted by popular obesity and diabetes drugs like Ozempic.

“Surgery increases our metabolism, stimulates the effectiveness of bile acids in our blood, and modulates our intestinal microbiome to help to improve our overall health,” he added.

“Bariatric surgery is beneficial to any patient with a body mass index of 30 and above according to the new guidelines by the ASMBS/ACS (the American Society for Metabolic and Bariatric Surgery and the American College of Surgeons) criteria for performing bariatric surgery,” said Floch.

However, Cutler pointed out that the people in the study who had not yet developed severe weight-related conditions actually showed the most improvement. For example, those who did not yet have diabetes saw the most dramatic response in their average blood sugar.

“This suggests that people who struggle with their weight but have not yet developed significant health conditions may actually benefit the most from surgery in terms of preventing these future health problems,” she said.

“Doctors and other providers who are considering the best time to suggest a referral to a bariatric surgeon may want to keep this in mind for their patients,” Cutler advised.

New research has found that bariatric surgery can lead to significant improvements in cardiometabolic health.

Those who were young, female, or white or who had not yet developed any obesity-associated health conditions saw the most improvement.

Bariatric surgery leads to a reduction in the visceral fat that is linked to cardiovascular disease and diabetes.

It also reduces inflammation and improves hormone balance.

Anyone with a BMI over 30 can benefit from bariatric surgery. However, those who have not yet developed obesity-related health conditions might benefit the most.