Hormonal
Bariatric surgery (specifically Roux-en-Y gastric bypass, sleeve gastrectomy, and biliopancreatic diversion) leads to greater improvements in cardiovascular risk factors (triglycerides, HDL cholesterol, fasting glucose, HbA1c) compared to non-surgical treatment, although blood pressure and total/LDL cholesterol changes are not significantly different.
Bariatric surgery improves key cardiovascular markers like triglycerides, HDL cholesterol, and blood glucose more effectively than non-surgical treatments. However, it does not significantly improve blood pressure or LDL cholesterol compared to lifestyle changes alone. Patients should expect to reduce or stop some medications under medical supervision.
Plasma triglyceride concentrations decreased more (mean difference −0.7 mmol/L (−1.0 to −0.4) and high density lipoprotein cholesterol concentrations increased more (mean difference 0.21 mmol/L (0.1 to 0.3)). Changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different.
Why this rating
Meta-analysis of RCTs, but high heterogeneity and limited follow-up.
Source
Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials
Viktoria Gloy et al. · BMJ · 2013
DOI 10.1136/bmj.f5934
More from this paper
- Bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy, or biliopancreatic diversion) produces significantly greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome compared to non-surgical treatment (diet, behavioral therapy, or pharmacotherapy) in individuals with a BMI ≥30, with effects sustained up to two years.Good
- Adjustable gastric banding is associated with less body weight loss and less improvement in glucose levels compared to Roux-en-Y gastric bypass, sleeve gastrectomy, and biliopancreatic diversion, although the difference in weight loss between banding and other surgeries was not statistically significant in this meta-analysis due to limited power.Moderate
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