Maddalena Gaeta1, Emanuele Rausa2, Alexis E Malavazos3, Luigi Bonavina4, Cornelius M Smuts5, Cristian Ricci6. 1. Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, Unit of Hygiene, University of Pavia, Via Strada Nuova 65, Pavia, Italy. 2. Division of General Surgery, Papa Giovanni XXIII Hospital, University of Milan, Bergamo, Italy. 3. Clinical Nutrition and Cardiovascular Prevention Unit, IRCCS Policlinico San Donato, San Donato, Italy. 4. Department of Biochemical Sciences for Health, Division of General Surgery, IRCCS Policlinico San Donato, University of Milan, Milan, Italy. 5. Centre of Excellence for Nutrition (CEN), North-West University, Thabo Mbeki Lane, 8., Potchefstroom, North West Province, 2520, South Africa. 6. Centre of Excellence for Nutrition (CEN), North-West University, Thabo Mbeki Lane, 8., Potchefstroom, North West Province, 2520, South Africa. Cristian.ricci@nwu.ac.za.
Abstract
BACKGROUND: Type II obesity represents a major pandemic and public health threat in high-income countries. Type II obesity increases the risk of all-cause and specific-cause mortality, and it is widely acknowledged that bariatric surgery represents the only effective therapeutic option in these patients. The aim of the present study was to estimate US population attributable risk for all-cause and cause-specific mortality in type II obese subjects undergoing weight loss as resulting from bariatric surgery alone and supplemented with behavioral intervention. METHODS: The American National Health and Nutrition Examination Survey linked to the US death registry updated to 2011 was used to estimate type II obesity prevalence and all-cause and specific cause of death for type II obese adults undergoing weight loss. Multivariate adjusted proportional hazard Cox models were used to estimate mortality risks. Statistical analyses were performed on the most updated version of the database (June 2017). RESULTS: A monotone positive trend for type II obesity was observed during the period 1999-2014 (p < 0.001). According to trend analysis, the rate of type II obesity in US adults is expected to rise up to 8.5%. Two- to sevenfold increased risk of all-cause and specific-cause mortality was observed for type II obese participants when compared to type I obese and overweight participants. Population attributable risk for all-cause and specific-cause mortality for type II obese subjects undergoing weight loss was ranging between 6 and 34%. CONCLUSIONS: Bariatric surgery supplemented with behavioral intervention can result in a relevant reduction of mortality if extensively applied to the US population.
BACKGROUND:Type II obesity represents a major pandemic and public health threat in high-income countries. Type II obesity increases the risk of all-cause and specific-cause mortality, and it is widely acknowledged that bariatric surgery represents the only effective therapeutic option in these patients. The aim of the present study was to estimate US population attributable risk for all-cause and cause-specific mortality in type II obese subjects undergoing weight loss as resulting from bariatric surgery alone and supplemented with behavioral intervention. METHODS: The American National Health and Nutrition Examination Survey linked to the US death registry updated to 2011 was used to estimate type II obesity prevalence and all-cause and specific cause of death for type II obese adults undergoing weight loss. Multivariate adjusted proportional hazard Cox models were used to estimate mortality risks. Statistical analyses were performed on the most updated version of the database (June 2017). RESULTS: A monotone positive trend for type II obesity was observed during the period 1999-2014 (p < 0.001). According to trend analysis, the rate of type II obesity in US adults is expected to rise up to 8.5%. Two- to sevenfold increased risk of all-cause and specific-cause mortality was observed for type II obeseparticipants when compared to type I obese and overweight participants. Population attributable risk for all-cause and specific-cause mortality for type II obese subjects undergoing weight loss was ranging between 6 and 34%. CONCLUSIONS: Bariatric surgery supplemented with behavioral intervention can result in a relevant reduction of mortality if extensively applied to the US population.
Entities:
Keywords:
Mortality; Obesity surgery; Population attributable risk; USA
Authors: Lars Sjöström; Anna-Karin Lindroos; Markku Peltonen; Jarl Torgerson; Claude Bouchard; Björn Carlsson; Sven Dahlgren; Bo Larsson; Kristina Narbro; Carl David Sjöström; Marianne Sullivan; Hans Wedel Journal: N Engl J Med Date: 2004-12-23 Impact factor: 91.245
Authors: Jacqueline Odom; Kerstyn C Zalesin; Tamika L Washington; Wendy W Miller; Basil Hakmeh; Danielle L Zaremba; Mohamed Altattan; Mamtha Balasubramaniam; Deborah S Gibbs; Kevin R Krause; David L Chengelis; Barry A Franklin; Peter A McCullough Journal: Obes Surg Date: 2009-06-25 Impact factor: 4.129