Increased Risk of Complications After Bariatric Surgery vs Medical Treatment

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Surgically treated patients had a greater likelihood of hypertension remission than medically treated patients.
Surgically treated patients had a greater likelihood of hypertension remission than medically treated patients.

HealthDay News — Bariatric surgery is associated with lower risks of obesity-related comorbidities but a clinically important increased risk for complications compared with medical treatment, according to a study published in the Journal of the American Medical Association, a theme issue on obesity.

Gunn Signe Jakobsen, MD, from Vestford Hospital Trust in Tonsberg, Norway, and colleagues conducted a cohort study to compare changes in obesity-related comorbidities in patients with severe obesity undergoing bariatric surgery or specialized medical treatment.

Treatment-seeking adult patients who underwent bariatric surgery (932 adults) or specialized medical treatment (956 adults) were followed from 2006 until death or through December 2015.

The researchers found that surgically treated patients had a greater likelihood of hypertension remission than medically treated patients (absolute risk, 31.9% vs 12.4%; relative risk, 2.1), and they had reduced likelihood of new-onset hypertension (absolute risk, 3.5% vs 12.2%; relative risk, 0.4).

They also had increased likelihood of diabetes remission (absolute risk, 57.5% vs 14.8%; relative risk, 3.9) and increased risk of new-onset depression (8.9% vs 6.5%; relative risk, 1.5), opioid treatment initiation (absolute risk, 19.4% vs 15.8%; relative risk, 1.3), and undergoing at least 1 additional gastrointestinal surgical procedure (31.3% vs 15.5%; relative risk, 2).

"Bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities," the authors write. "The risk for complications should be considered in the decision-making process."

Reference

Jakobsen GS, Småstuen MC, Sandbu R, et al. Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA. 2018; 319(2):291-301.

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