Objective: To examine the effect of a large, long standing and intentional weight reduction on the incidence of diabetes, hypertension and lipid disturbances in severely obese individuals as compared to weight-stable obese controls.
Research methods and procedures: The ongoing prospective SOS (Swedish Obese Subjects) intervention consists of a surgically treated group and a matched control group obtaining conventional obesity treatment. This report is based on 845 surgically treated patients and 845 controls (BMI 41.0+/-4.6 kg/m2 (mean+/-standard deviation [S])) followed for 2 years.
Results: Surgically treated patients lost 28+/-15 kg and controls 0.5+/-8.9 kg (p<0.0001). Two-year incidence of hypertension, diabetes, hyperinsulinemia, and lipid disturbances was compared in the two treatment groups. Adjusted odds ratios (95% CI) for the surgically treated group versus controls were 0.38 (0.22, 0.65) for hypertension, 0.02 (0.00, 0.16) for diabetes, 0.10 (0.03, 0.28) for hyperinsulinemia, 0. 10 (0.04, 0.25) for hypertriglyceridemia, 0.28 (0.16, 0.49) for low HDL-cholesterol and 1.24 (0.84, 1.8) for hypercholesterolemia. Compared to controls, the 2-year recovery rates from hypertension, diabetes, hypo-HDL, and hypertriglyceridemia were significantly higher in the surgically treated group.
Discussion: Intentional weight loss in the obese causes a marked reduction in the 2-year incidence of hypertension, diabetes and some lipid disturbances. The results suggest that severe obesity can and should be treated.