Bariatric Surgery: Can It Perform Benefits or Risks?

Obesity is associated with an increased incidence of heart failure (HF), myocardial infarction (MI), stroke, and death. Weight loss has become a standard recommendation for all patients with cardiovascular disease (CVD) and coexisting obesity. Bariatric surgery has been shown to reduce cardiovascular risk factors significantly; however, whether surgery can reduce major adverse cardiovascular events (MACE), especially in patients with established cardiovascular disease. Bariatric surgery has been associated with a significant reduction in daily insulin requirement and a considerable reduction in body mass index, resulting in long-term results. Furthermore, studies suggest that bariatric surgery for type 1 diabetes results in the improvement of comorbidities related to obesity including hypertension and dyslipidemia. Obesity is thought to be the strongest risk factor for the development of type 2 diabetes. Bariatric surgery has emerged as the single most effective treatment option for type 2 diabetes and obesity. The individuals who underwent bariatric surgery compared with medical/lifestyle intervention had superior glycemic control with less diabetes medication use and higher rates of diabetes remission. Obesity is a pro-inflammatory condition in which some cytokines such as leptin, a pro-inflammatory protein, are elevated and adiponectin, an anti-inflammatory protein, is decreased. In patients undergoing weight reduction surgeries, these hormone levels behave paradoxically. It is not known whether bariatric surgery protects against the development of autoinflammatory or autoimmune conditions; nevertheless, changes occurring in the immune system are incompletely understood. Patients undergoing bariatric surgery show immunological changes which might eventually lead to developing an autoimmune disease.