A new study has found that gastric bypass surgery, besides enabling severely obese people to lose weight, may also help their overly stressed hearts return to more normal function and appearance. The study appeared in the Feb. 8 issue of the Journal of the American College of Cardiology.
Senior study author Dr. Sheldon Litwin, chief of cardiology at the Medical College of Georgia explained that obesity may lead to many types of heart problems, including heart failure, atrial fibrillation (an abnormal heart rhythm) and death. Although the exact link is unclear, obese people often show signs of structural changes to the heart, including excess heart muscle mass in the left ventricle and enlargement of the right ventricular cavity. Both are linked to heart failure and other problems he said.
The team, for this study followed more than 400 severely obese people with an average age of 42 who had gastric bypass surgery. This surgery reduces the size of the stomach to prevent excessive eating. They were compared with a reference group of more than 300 severely obese individuals who did not have the weight-loss surgery.
Over two years of follow up, patients’ body mass index (BMI) fell from an average of nearly 48 (morbidly obese) to about 32. Their average weight loss was about 100 pounds, Litwin said. BMI over 30 is considered obese.
As an added advantage these patients had smaller waistlines, lower blood pressure and heart rate, healthier cholesterol levels and less insulin resistance, a precursor to diabetes, the researchers found. Plus on echocardiograms the hearts of these patients were seen to be “remodelling” that included a reduction in the left ventricular mass and right ventricular cavity area. This indicated that heart is less stressed and is not having to work as hard pumping blood and has returned to a more normal shape and function, Litwin said.
Litwin said, “We know obese people get cardiovascular disease more often than non-obese people…One of the questions out there is: Is it reversible if they lose weight? The answer is yes.”
Figures reveal that bariatric surgeries have increased steadily in the United States from 16,800 in 1992 to about 205,000 in 2007, according to the American Society for Metabolic & Bariatric Surgery. In fact the proportion of obese people having the surgery is still small at 1% annually said Dr. Lee Kaplan, director of the Massachusetts General Hospital Weight Center. Litwin explained, “Would it be better if people could lose weight by eating better and exercising more? Probably yes…But in general those lifestyle changes are ineffective, particularly in people who are severely obese.”
Dr. Kaplan added, “There are innumerable known benefits to gastric bypass surgery on most of the 60-odd diseases associated with obesity a patient may have…The question isn’t if gastric bypass works. It does work. The issue has been at what cost, both in terms of health risks and financial? This study provides evidence there are additional substantial benefits with respect to heart muscle function, and we should consider gastric bypass more often in the appropriate patients.”
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