Research
Mixed
Bariatric surgery is associated with a significantly lower risk of incident macrovascular disease (composite of coronary and cerebrovascular events) compared to usual medical care in patients with type 2 diabetes and severe obesity.
For patients with severe obesity and type 2 diabetes, bariatric surgery is associated with a significantly lower risk of heart attacks and strokes compared to standard medical care. While lifestyle and medication are important, they may not be sufficient to prevent these major cardiovascular events in this population.
ModerateSupportsHIGH confidence
Bariatric surgery was associated with a lower composite incidence of macrovascular events at 5 years (2.1% in the surgical group vs 4.3% in the nonsurgical group; hazard ratio, 0.60 [95% CI, 0.42-0.86])
Why this rating
Retrospective matched cohort study; strong observational evidence but not randomized.
Source
Association Between Bariatric Surgery and Macrovascular Disease Outcomes in Patients With Type 2 Diabetes and Severe Obesity
David Fisher et al. · JAMA · 2018
DOI 10.1001/jama.2018.14619
cohort · n=20235Cited 304×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Bariatric surgery is associated with a significantly lower risk of incident coronary artery disease (CAD) compared to usual medical care in patients with type 2 diabetes and severe obesity.Moderate
- Bariatric surgery is NOT associated with a significantly lower risk of incident cerebrovascular disease (stroke) compared to usual medical care in patients with type 2 diabetes and severe obesity at 5 years.Moderate
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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