The Comparative Effects of Bariatric Surgery on Weight and Type 2 Diabetes

Pierre Lévy, Martin Fried, Ferruccio Santini and Nick Finer
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Pierre Lévy: LEDa - Laboratoire d'Economie de Dauphine - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres
Martin Fried: ISCARE - ISCARE
Ferruccio Santini: Department of Endocrinology and Metabolic Diseases - LUMC - Leiden University Medical Center - Universiteit Leiden = Leiden University
Nick Finer: Wellcome Trust Clinical Research Facility - Birmingham Children's Hospital

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Abstract: Background: Epidemiological evidence confirms that risk of developing type 2 diabetes is related to weight gain. Weight reduction is beneficial as relative risk is reduced to 0.13 for weight loss >20 kg. This raises the question of effectiveness of bariatric surgery on 1) weight loss and 2) diabetes-related outcomes in morbidly obese patients.Methods: We reviewed the literature using Medline. Only 2 meta-analyses reporting on both outcomes were included, as well as 50 systematic reviews or primary studies.Results: Meta-analyses mainly based on case series data as well as controlled studies confirm that bariatric surgery is highly effective in obtaining weight reduction in morbidly obese patients up to 60% of the excess weight, along with resolution of preoperative diabetes in more than 75% of cases. Among bariatric surgery techniques, malabsorptive procedures (biliopancreatic diversion and gastric bypass) appear to be more effective on both outcomes than restrictive procedures (gastroplasty and gastric banding).Conclusion: Even if more studies are needed to confirm current evidence, bariatric surgery is effective for controlling diabetes. It appears as an efficient strategy from economic modeling due to savings from reduction in diabetes-related costs.

Keywords: weight loss; morbid obesity; type 2 diabetes mellitus; Bariatric surgery; literature review; treatment outcome (search for similar items in EconPapers)
Date: 2007
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Published in Obesity Surgery, 2007, 17 (9), ⟨10.1007/BF02802098⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01293732

DOI: 10.1007/BF02802098

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