Use of sleeve gastrectomy may be valid for some people with class 1 obesity – medwireNews

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medwireNews: Study findings published in JAMA Network Open suggest that for people with class 1 obesity, sleeve gastrectomy is associated with greater weight loss and diabetes remission than lifestyle intervention, but the procedure is also linked to increased incidence of substance use disorder and self-harm.

Therefore, “sleeve gastrectomy may be a treatment option in selected patients with metabolic comorbidity and class 1 obesity,” but “careful preoperative evaluation and optimization of risk factors along with close support and follow-up after surgery remain important,” say Erik Stenberg (Örebro University Hospital, Sweden) and colleagues.

The study included 1216 adults with a BMI of 30 to less than 35 kg/m2 who underwent sleeve gastrectomy in 2012–2017, and 2432 matched individuals who underwent intensive lifestyle modification.

People in the surgery group had significantly greater weight loss at 1 year compared with the nonoperative participants, with a mean difference of 10.7 kg, increasing to 12.0 kg at 2 years.

During a median 5.1 years of follow-up, individuals in the surgery group without diabetes at baseline had a significant 40% lower risk for incident use of diabetes drugs than those in the nonoperative group. Similarly, people with drug-treated diabetes in the surgery group had a greater 2-year diabetes remission rate (48.4 vs 22.0%).

However, “[d]espite these improvements, no differences in occurrence of major cardiovascular events or mortality were seen” with sleeve gastrectomy versus lifestyle management, say the researchers. They also note that people in the surgery group had significant 86% and 81% higher risks for substance use disorder and self-harm, respectively, than nonoperative participants.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

JAMA Netw Open 2022; doi:10.1001/jamanetworkopen.2022.23927

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