A new analysis of the Swedish Obese Subjects (SOS) study shows that despite considerably greater and sustained weight loss than conventionally treated controls, patients treated with bariatric surgery continued to use just as much inpatient and non-primary outpatient care than the controls during a 20 year follow-up period. However, cost savings in the surgery group were seen for medications that treat diabetes and cardiovascular disease between year 7 and 20, resulting in lower overall drug costs.
This analysis was conducted by researchers at Karolinska Institutet and the Sahlgrenska Academy, University of Gothenburg, and published in a theme issue on obesity of the prestigious Journal of the American Medical Association (JAMA).
The SOS study is an ongoing, prospective, controlled intervention study conducted in the Swedish health care system that included 2,010 adults who underwent bariatric surgery and 2,037 contemporaneously matched controls recruited between 1987 and 2001. Inclusion criteria were age 37 years to 60 years and body mass index of 34 or higher in men and 38 or higher in women. Of the surgery patients, 13 percent underwent gastric bypass, 19 percent gastric banding, and 68 percent vertical-banded gastroplasty. Controls received conventional obesity treatment.
Earlier analyses of the SOS data have shown that surgically induced weight loss results in sustained weight loss, reduced incidence of diabetes, cardiovascular events, and cancer, as well as improved 10- to 15-year survival. The JAMA theme issue on obesity is published every tenth year. The current analysis was funded by AFA Insurance. The SOS study received funding from the Swedish Research Council, the Swedish Foundation for Strategic Research (SSF), and several pharmaceutical companies.
Weight Loss and Health Care Use During 20 Years Following Bariatric Surgery. Neovius M, Narbro K, Keating C, Pelttonen M, Sjöholm K, Ågren G, Sjöström L, Carlsson L. JAMA 2012;308(11):1132-41, online 18 September 2012 doi:10.1001/2012.jama.11164