Bariatric Surgery Improves Cholesterol Levels and Reduces Risk of Heart Disease
Bariatric surgery is effective in improving cholesterol and lipid levels, important risk factors for heart disease, according to a new joint scientific statement by the National Lipid Association (NLA), American Society for Metabolic and Bariatric Surgery (ASMBS), and Obesity Medicine Association (OMA). The statement was published in the January/February issue of the Journal of Clinical Lipidology, the official journal of the NLA.
Carl Orringer, MD
"Patients who have excess weight or obesity may store over 50 percent of their body cholesterol in body fat," said Carl Orringer, MD, president of the NLA and associate professor of medicine at the University of Miami Miller School of Medicine. "Bariatric procedures that promote body fat loss can reduce cholesterol blood levels, especially bariatric surgeries that result in the greatest amount of weight loss."
According to the statement, a reduction in body fat, as well as favorable alterations in endocrine and inflammatory homeostasis are among the mechanisms by which bariatric procedures may improve dyslipidemia. Bariatric procedures may also have favorable effects on bile acid metabolism and the intestinal microbiome, which may also improve dyslipidemia.
The first part of the statement, published in February, focuses on the mechanism by which bariatric surgery affects cholesterol and lipid levels. The second part of the statement is in press at Surgery for Obesity and Related Diseases (SOARD), the official journal of the ASMBS.
"Bariatric surgery is well known to improve diabetes mellitus in patients with obesity," said Harold Bays, MD, an executive officer of the NLA and lead author of the scientific statement. "But what is less well recognized is the beneficial effect bariatric surgery may have on cholesterol levels, which is one of the most important risk factors for heart disease. In fact, it is sometimes forgotten that decades ago, gastrointestinal surgery was proven effective as a treatment for high cholesterol," said Dr. Bays.
Wendy Scinta, MD
"Disease-reversing weight loss of 10-25 percent of body weight can occur using both medical and surgical means. While as little as 10 percent weight loss may not return an individual with obesity to a normal body mass index (BMI), the beneficial health impacts are well documented and include a profound improvement in lipid profile and reduction in other cardiac risk factors, including blood pressure and fasting glucose levels," said Wendy Scinta, MD, MS, president-elect of the OMA (formerly American Society of Bariatric Physicians) and medical director of Medical Weight Loss of NY.
"We believe this important scientific statement will assist clinicians in better engaging with patients on the treatment of obesity and the consideration of bariatric surgery as an important option for those with risk factors for heart disease," said Raul Rosenthal, MD, president, ASMBS.