Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery
Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long‐term, prospective, controlled trial to provide...
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| Published in | Journal of internal medicine Vol. 273; no. 3; pp. 219 - 234 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
England
01.03.2013
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0954-6820 1365-2796 1365-2796 |
| DOI | 10.1111/joim.12012 |
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| Abstract | Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long‐term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37–60 years and body mass index (BMI) was ≥34 kg m−2 in men and ≥38 kg m−2 in women. Here, we review the key SOS study results published between 2004 and 2012. Follow‐up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were −23%, −17%, −16% and −18% in the surgery group and 0%, 1%, −1% and −1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long‐term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54–0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. |
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| AbstractList | Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long-term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37-60 years and body mass index (BMI) was ≥34 kg m(-2) in men and ≥38 kg m(-2) in women. Here, we review the key SOS study results published between 2004 and 2012. Follow-up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were -23%, -17%, -16% and -18% in the surgery group and 0%, 1%, -1% and -1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long-term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54-0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised.Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long-term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37-60 years and body mass index (BMI) was ≥34 kg m(-2) in men and ≥38 kg m(-2) in women. Here, we review the key SOS study results published between 2004 and 2012. Follow-up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were -23%, -17%, -16% and -18% in the surgery group and 0%, 1%, -1% and -1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long-term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54-0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long-term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37–60 years and body mass index (BMI) was ≥34 kg m−2 in men and ≥38 kg m−2 in women. Here, we review the key SOS study results published between 2004 and 2012. Follow-up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were −23%, −17%, −16% and −18% in the surgery group and 0%, 1%, −1% and −1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long-term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54–0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long-term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37-60 years and body mass index (BMI) was ≥34 kg m(-2) in men and ≥38 kg m(-2) in women. Here, we review the key SOS study results published between 2004 and 2012. Follow-up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were -23%, -17%, -16% and -18% in the surgery group and 0%, 1%, -1% and -1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long-term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54-0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects (SOS) study is the first long‐term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37–60 years and body mass index (BMI) was ≥34 kg m−2 in men and ≥38 kg m−2 in women. Here, we review the key SOS study results published between 2004 and 2012. Follow‐up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were −23%, −17%, −16% and −18% in the surgery group and 0%, 1%, −1% and −1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long‐term reduction in overall mortality (primary endpoint) [adjusted hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.54–0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR=0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR=0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio (OR) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects ( SOS ) study is the first long‐term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37–60 years and body mass index ( BMI ) was ≥34 kg m −2 in men and ≥38 kg m −2 in women. Here, we review the key SOS study results published between 2004 and 2012. Follow‐up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were −23%, −17%, −16% and −18% in the surgery group and 0%, 1%, −1% and −1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long‐term reduction in overall mortality (primary endpoint) [adjusted hazard ratio ( HR ) = 0.71, 95% confidence interval ( CI ) 0.54–0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR =0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR =0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio ( OR ) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised. |
| Author | Sjöström, L. |
| Author_xml | – sequence: 1 givenname: L. surname: Sjöström fullname: Sjöström, L. organization: The University of Gothenburg |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23163728$$D View this record in MEDLINE/PubMed https://gup.ub.gu.se/publication/174873$$DView record from Swedish Publication Index |
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| References | 2010; 12 2001; 344 2012; 120 1997; 315 2012; 366 2004; 27 2004; 28 2004; 240 2004; 5 1997; 1 1992; 16 1997; 5 2012; 367 2008; 1 2007; 31 1992; 55 2005; 28 1991; 115 2011; 124 2001; 134 2009; 10 1977; 39 2000; 13 1995; 24 1984; 679 2000; 10 2000; 160 2009; 122 2002; 346 2011; 26 2012; 26 2011; 28 2011; 162 2006; 368 2007; 1 2003; 289 2009; 208 2012; 20 1996; 20 2003; 284 1983; 67 2009; 17 2011; 377 2002; 252 2000; 23 2008; 16 1992; 268 2010; 363 2009; 374 2008 1999; 23 2005; 86 2000; 151 2011; 35 1975; 31 2005 2006; 3 2011; 34 1995; 19 2009; 373 1995; 18 2012; 36 2012; 35 1970; 19 1999; 7 1999; 149 2005; 45 2012; 307 2006; 355 1987; 16 2012; 308 2007; 356 2004; 199 2007; 357 2004; 351 2009; 30 2006; 83 1993; 119 1995; 48 2010; 251 1998; 148 2005; 3 2009; 4 2013 2008; 42 2008; 299 2003; 104 1988; 319 1998; 6 2012; 159 1995; 141 2012; 42 2008; 371 2005; 13 Waaler H (e_1_2_8_42_1) 1984; 679 e_1_2_8_26_1 e_1_2_8_49_1 e_1_2_8_68_1 e_1_2_8_5_1 e_1_2_8_9_1 e_1_2_8_22_1 e_1_2_8_45_1 e_1_2_8_64_1 e_1_2_8_87_1 e_1_2_8_41_1 e_1_2_8_83_1 e_1_2_8_19_1 e_1_2_8_15_1 e_1_2_8_38_1 e_1_2_8_57_1 e_1_2_8_91_1 e_1_2_8_11_1 e_1_2_8_34_1 e_1_2_8_53_1 e_1_2_8_76_1 e_1_2_8_101_1 e_1_2_8_30_1 e_1_2_8_72_1 e_1_2_8_29_1 e_1_2_8_25_1 e_1_2_8_48_1 e_1_2_8_2_1 e_1_2_8_6_1 Norris SL (e_1_2_8_60_1) 2005 e_1_2_8_21_1 e_1_2_8_67_1 e_1_2_8_44_1 e_1_2_8_86_1 e_1_2_8_63_1 e_1_2_8_82_1 e_1_2_8_18_1 e_1_2_8_14_1 e_1_2_8_37_1 e_1_2_8_79_1 e_1_2_8_94_1 e_1_2_8_90_1 e_1_2_8_98_1 e_1_2_8_10_1 e_1_2_8_56_1 e_1_2_8_33_1 e_1_2_8_75_1 e_1_2_8_52_1 e_1_2_8_102_1 e_1_2_8_71_1 e_1_2_8_28_1 e_1_2_8_24_1 e_1_2_8_47_1 Sjöström L (e_1_2_8_7_1) 1992; 55 Brolin RE (e_1_2_8_50_1) 1987; 16 e_1_2_8_3_1 e_1_2_8_81_1 e_1_2_8_20_1 e_1_2_8_43_1 e_1_2_8_66_1 e_1_2_8_89_1 e_1_2_8_62_1 e_1_2_8_85_1 Narbro K (e_1_2_8_99_1) 1996; 20 e_1_2_8_17_1 e_1_2_8_13_1 e_1_2_8_36_1 e_1_2_8_59_1 Norris SL (e_1_2_8_58_1) 2005 e_1_2_8_70_1 e_1_2_8_97_1 e_1_2_8_32_1 e_1_2_8_55_1 e_1_2_8_78_1 e_1_2_8_51_1 e_1_2_8_93_1 e_1_2_8_46_1 Sjöström L (e_1_2_8_40_1) 2013 e_1_2_8_27_1 e_1_2_8_80_1 e_1_2_8_4_1 Orozco LJ (e_1_2_8_69_1) 2008 e_1_2_8_8_1 e_1_2_8_88_1 e_1_2_8_23_1 e_1_2_8_65_1 e_1_2_8_84_1 e_1_2_8_61_1 (e_1_2_8_74_1) 2011; 34 e_1_2_8_39_1 e_1_2_8_16_1 e_1_2_8_92_1 Sjöström L (e_1_2_8_35_1) 1992; 16 e_1_2_8_96_1 e_1_2_8_100_1 e_1_2_8_31_1 e_1_2_8_77_1 Grunstein RR (e_1_2_8_95_1) 1995; 19 e_1_2_8_12_1 e_1_2_8_54_1 e_1_2_8_73_1 |
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| SubjectTerms | Adult aged 40-64 years bariatric surgery Bariatric Surgery - mortality Body Mass Index Body Weight cardiovascular risk-factors Clinical Medicine Comorbidity Diabetes Mellitus - epidemiology Diabetes Mellitus - prevention & control Diabetic Angiopathies - epidemiology Diabetic Angiopathies - surgery Female finnish diabetes prevention gastric bypass-surgery health-care use Humans Incidence incidence of diabetes intentional weight-loss Klinisk medicin left-ventricular mass life-style intervention long-term Male Middle Aged mortality myocardial infarction Neoplasms - epidemiology Neoplasms - prevention & control obesity Obesity, Morbid - epidemiology Obesity, Morbid - surgery randomized controlled-trial Stroke - epidemiology Stroke - prevention & control stroke and cancer Sweden - epidemiology Treatment Outcome Weight Loss |
| Title | Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery |
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