Weight-Loss Surgery Produces Unexpected Drop in Heart Disease

A Stanford University School of Medicine study using new measures of Heart disease risk shows that gastric bypass surgery reduces the risk of Heart disease even more than previously believed. The researchers say the finding underscores the value of the surgery for extremely overweight people, whose obesity puts them in danger of Heart attack, Stroke and other cardiovascular illness.

The researchers measured biochemical cardiovascular risk factors in 371 patients before surgery and again 12 months after gastric bypass surgery, adding three new tests to the standard panel of cholesterol and triglyceride assays. They saw improvements in all cardiac risk factors, with the most significant improvements for triglycerides and one of the new tests: C-reactive protein.

"Medication with statins - the most effective non-surgical treatment available - lowers C-reactive protein by about 16 percent. But we found that gastric bypass lowered it by 50 percent.

That's a pretty significant improvement over what's been considered state-of-the-art therapy," said senior author John Morton, MD, assistant professor of surgery at the Stanford School of Medicine and director of bariatric surgery at Stanford Hospital.

Lead author Brandon Williams, MD, a general surgery resident, will present the study's findings at 7:45 a.m. Eastern time on June 30 at the annual scientific meeting of the American Society for Bariatric Surgery, held June 26-July 1 in Orlando, Fla.

Gastric bypass surgery, the most common form of weight-loss surgery, reduces the stomach's size to limit the amount of food intake and bypasses more than 35 inches of the approximately 20-foot-long small intestine, which cuts down on nutrient absorption.

The number of gastric bypass surgeries has shot up in recent years, increasing from 29,000 procedures in 1999 to about 141,000 in 2004, according to the bariatric surgery society. The procedure poses about a 2 percent risk of mortality and requires lifelong changes in eating habits - but it's a life-saving operation for most morbidly obese individuals, Morton said.

"This operation is reserved for morbidly obese people, not the pleasantly plump," Morton said. "Being morbidly obese carries a pretty significant risk of premature death, in large part because of Heart disease. The risk of premature death for the morbidly obese is about three times the risk of the general population."

Though for most obese people, the most compelling reasons to lose weight have to do with improvements in lifestyle, the health benefits are tremendous, Williams said. He expects that the new study will encourage physicians to discuss the surgery with obese patients who are at risk of . And he hopes that the findings will push insurance companies that deny coverage for the procedure to change their policies.