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Bariatric surgery: a systematic review and meta-analysis
Henry Buchwald1, Yoav Avidor, Eugene Braunwald
1Department of Surgery, University of Minnesota, Minneapolis 55455, USA. buchw001@umn.edu
JAMA
|October 14, 2004
Summary
Bariatric surgery is effective for significant weight loss in morbidly obese patients. It also leads to substantial resolution or improvement in obesity-related comorbidities like diabetes and hypertension.
Area of Science:
- Metabolic and Bariatric Surgery
- Obesity Medicine
- Surgical Outcomes Research
Background:
- Morbid obesity affects 5% of the US population and is often resistant to traditional treatments.
- Bariatric surgery is a generally effective treatment for morbid obesity.
Purpose of the Study:
- To evaluate the impact of bariatric surgery on weight loss.
- To assess operative mortality outcomes.
- To determine the effect on diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.
Main Methods:
- A comprehensive literature search was conducted across major databases (MEDLINE, Current Contents, Cochrane Library) from 1990 to 2003.
- 2738 citations were screened, with 136 studies and 22,094 patients included in the meta-analysis.
- Data extraction focused on weight loss, mortality, and comorbidity resolution following various bariatric procedures.
Main Results:
- Mean excess weight loss ranged from 47.5% (gastric banding) to 70.1% (biliopancreatic diversion/duodenal switch).
- Operative mortality was low, ranging from 0.1% to 1.1% depending on the procedure.
- Significant resolution or improvement was observed for diabetes (86.0%), hyperlipidemia (≥70%), hypertension (78.5%), and obstructive sleep apnea (83.6%).
Conclusions:
- Bariatric surgery is an effective intervention for achieving substantial weight loss in morbidly obese individuals.
- The majority of patients experience significant improvement or complete resolution of major obesity-related comorbidities.
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