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Bariatric surgery significantly reduces all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE) compared to medical therapy in patients with severe obesity and Type 2 Diabetes.
For severe obesity and Type 2 Diabetes, bariatric surgery is the most effective treatment for reducing heart disease risk and death. It significantly lowers the risk of heart attack, stroke, and heart failure compared to medical therapy alone. Discuss surgical options with a specialist if lifestyle changes and medications are insufficient.
Bariatric surgery has been shown to be associated with reduction in all-cause mortality (HR 0.55), CV mortality (HR 0.59), incidence of heart failure (HR 0.5), myocardial infarction (HR 0.58) and stroke (HR 0.64, p <0.001 vs control for all interactions)... The results from the two most recent large observational studies... demonstrated significant probability of reduction in major adverse cardiovascular events (MACE)
Why this rating
Based on prospective/retrospective cohort studies and some RCTs, but fewer large-scale CVO RCTs compared to pharmacotherapy.
Source
A review of the evidence on cardiovascular outcomes from obesity treatment
Roshaida Abdul Wahab et al. · Obesity Pillars · 2023
DOI 10.1016/j.obpill.2023.100071
More from this paper
- GLP-1 receptor agonists (specifically liraglutide, semaglutide, and dulaglutide) significantly reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes and high cardiovascular risk, independent of baseline BMI.Strong
- SGLT2 inhibitors (specifically empagliflozin and canagliflozin) reduce major adverse cardiovascular events (MACE) in patients with Type 2 Diabetes, with empagliflozin also reducing heart failure hospitalizations.Strong
- Intensive lifestyle intervention in patients with Type 2 Diabetes and obesity does not significantly reduce major cardiovascular events compared to standard care, although weight loss of 10% or more is associated with a lower risk.Good
Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
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