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PhD project: Long-term outcomes of bariatric surgery and the impact of socioeconomic status

In contrast to traditional obesity treatment strategies, such as nutritional therapy, physical activity, and pharmaceuticals, bariatric surgery has proven to be a more efficient strategy to lose body weight. Gastric bypass, however, is an invasive procedure causing changes in hormonal secretion and uptake of nutrition among other things. Little is known about the long-term health effects of bariatric surgery. This thesis will estimate the long-term risk of developing lifestyle related diseases like diabetes and cardiovascular disease in patients receiving gastric bypass. Further, the risk of developing alcohol use disorder after surgery will be evaluated.

Purpose

The aim of the study is to investigate whether there is a difference in long-term risk of developing cardiovascular disease, diabetes and alcohol use disorder between bariatric surgery patients and an obese reference group who have not received bariatric surgery. Further, the aim is to investigate if there is an association between socioeconomic factors and long-term risk of cardiovascular disease and diabetes?
The hypotheses of the thesis are:

  • Bariatric surgery patients have a lower long-term risk of cardiovascular disease and diabetes compared to other obese individuals who have not undergone bariatric surgery.
  • The relative risks of cardiovascular disease and diabetes, as assessed above, differ according to socioeconomic status.
  • Bariatric surgery patients have a higher risk of developing alcohol problems compared to other obese individuals who have not undergone bariatric surgery.

Methods

The study is a register-based cohort study with prospectively collected data. The study population consist of all bariatric surgery patients in Denmark from 2005-2013 (exposed group) and a reference group (unexposed group) matched by gender, age and BMI. The reference group is derived from the Danish SUSY/KRAM/NATSUP studies conducted from 2005-2013 where BMI was collected for all participants.
Incidence rates of diabetes, cardiovascular disease and alcohol use disorder will be calculated for each group and compared.

Project period

2017-2020.

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