Bariatric surgery tied to lessened use of lipid-lowering, cardiovascular, and antidiabetic medications

This Original Investigation is published in JAMA Surgery.

It is already known that Bariatric surgery resolves conditions like hyperlipidemia, cardiovascular disease, and diabetes. More research and data should be needed regarding long-term postoperative trajectories of medications for these conditions. The data remains scarce in this context.

Researchers in the present study researched this background in a population-based cohort study.

(Sweden and Finland) and included individuals diagnosed with obesity.

The key results of the study are:

• Twenty-six thousand three hundred ninety-six patients underwent bariatric surgery, either gastric bypass or sleeve gastrectomy.
• There was a decrease in the proportion of lipid-lowering medication following bariatric surgery from 20.3 % ( baseline) to 12.9% (after two years) and 17.6% (after 15 years).
• The proportion of lipid-lowering medication increased in the no-surgery group from 21.0% (at baseline) to 44.6% (15 years).
• There was a decrease in Cardiovascular medications used by bariatric surgery patients from 60.2% at baseline to 43.2% after two years. It increased to 74.6% after 15 years. In the surgery group, it increased from 54.4% at baseline to 83.3% after 15 years.
• In the bariatric surgery group, there was a decrease in the use of Antidiabetic medications, from 27.7% at baseline to 10.0% after two years. It increased to 23.5% after 15 years. In the surgery group, antidiabetic medicine use increased from 27.7% (baseline) to 54.2% after 15 years.

Concluding further, they said bariatric surgeries reduce the use of lipid-lowering and antidiabetic medications (long-lasting reduction) compared with no surgery for obesity. This reduction was only transient in the case of cardiovascular medicines.

The key strengths of the study were long and complete follow-up, population-based design, matching of comparable control patients with morbid obesity, and the large sample size retrieved from 2 countries.

Further reading:

Kauppila JH, Markar S, Santoni G, Holmberg D, Lagergren J. Temporal Changes in Obesity-Related Medication After Bariatric Surgery vs No Surgery for Obesity. JAMA Surg. Published online May 24, 2023. doi:10.1001/jamasurg.2023.0252