Study: Obesity surgery might cut diabetics’ health risks

SEATTLE — Obesity surgery may dramatically lower the danger of heart attacks and strokes in patients with diabetes, new research suggests.

The study tracked about 20,000 severely obese patients with Type 2 diabetes. Those who had weight loss surgery had a 40 percent lower chance of developing a heart attack or stroke in the five years following surgery compared to those who got usual care with diabetes medicines or insulin.

Other research has shown obesity surgery can reverse and even prevent diabetes. Taken together, it means doctors should discuss weight loss surgery more often, said study co-author Dr. David Arterburn of Kaiser Permanente Washington Health Research Institute in Seattle.

Doctors usually mention insulin and pills, “but it’s not always brought up that weight loss surgery is another available treatment option,” Arterburn said.

Results were published Tuesday in the Journal of the American Medical Association.

The study can’t prove cause and effect because patients weren’t randomly assigned to get surgery. The researchers tried to match patients for gender, age, blood sugar levels and other factors. But other things they didn’t account for could have contributed to the surgery patients’ better results.

Everyone in the study had a BMI, or body mass index, of at least

35. For instance, someone who is 5-foot-8-inches and weighs 230 pounds has a BMI of 35.

Of the more than 5,300 who had surgery, most had gastric bypass, the most common type of stomach-shrinking operation. Some had gastric sleeve or gastric band procedures. The rest, nearly 15,000 people, had usual care.

Obesity surgery can cost $20,000 to $25,000. Insurers are increasingly covering it, but some impose strict limits.

The new findings suggest insurance coverage should be expanded for the right patients, Dr. Sayeed Ikramuddin of the University of Minnesota wrote in an accompanying editorial.

Surgery is thought to help by affecting hormones, gut bacteria and other substances that affect how the body handles insulin and blood sugar. Weight loss without surgery also helps but is difficult for many people.