Generated Narrative: Citation 104116 version: 32; Last updated: 2025-10-13 09:55:39+0000; Language: en Profile: JournalArticleCitation ArtifactPublicationStatus: Active url: https://fevir.net/resources/Citation/104116 identifier: FEvIR Object Identifier/104116, https://pubmed.ncbi.nlm.nih.gov/29340680 title: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort status: Active date: 2022-09-06 14:07:55+0000 author: Brian S. Alper: , Computable Publishing®: MEDLINE-to-FEvIR Converter: , Joanne Dehnbostel: publisher: Computable Publishing LLC contact: support@computablepublishing.com description: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide. UseContexts - Code Value[x] * Citation Classification Type: fevir-platform-use (FEvIR Platform Use) Project Specific copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ approvalDate: 2018-01-26 lastReviewDate: 2022-03-30 Summaries - Style Text * Computable Publishing Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities [Journal Article]. Contributors: Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. In: JAMA, PMID 29340680. Published January 16, 2018. Available at: https://pubmed.ncbi.nlm.nih.gov/29340680/. classification type: Citation Source classifier: MEDLINE classification type: MEDLINE Citation Owner classifier: National Library of Medicine, Index Section currentState: Medline Citation Status of MEDLINE, PubMed PublicationStatus of ppublish statusDate activity: PubMed Pubstatus of Entrez period: ?? --> 2018-01-18 06:00:00+0000 statusDate activity: PubMed Pubstatus of PubMed period: ?? --> 2018-01-18 06:00:00+0000 statusDate activity: PubMed Pubstatus of Medline period: ?? --> 2018-01-27 06:00:00+0000 citedArtifact identifier: https://pubmed.ncbi.nlm.nih.gov/29340680, pii/2669729, https://doi.org/10.1001/jama.2017.21055, https://www.ncbi.nlm.nih.gov/pmc//PMC5833560 Titles - Type Text * Primary title Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities. Abstracts - Type Text * Primary human use Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). Exposures: Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. Main Outcomes and Measures: Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. Results: Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P < .001). Conclusions and Relevance: Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. 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title: JAMA publisherLocation: United States citedMedium: internet volume: 319 issue: 3 articleDate: 2018-01-16 pageString: 291-301 webLocation classifier: Abstract url: https://pubmed.ncbi.nlm.nih.gov/29340680/ webLocation classifier: DOI Based url: https://doi.org/10.1001/jama.2017.21055 classification type: Publishing Model classifier: Print classification type: Chemical classifier: Ferritins classification type: Publication type classifier: Comparative Study, Journal Article classification type: Citation subset classifier: IM classification type: MeSH heading artifactAssessment: ArtifactAssessment: artifact[x] = this resource classification type: Knowledge Artifact Type classifier: Journal Article artifactAssessment: Classifier added by Computable Publishing LLC contributorship complete: true entry contributor: Jakobsen GS forenameInitials: GS affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Småstuen MC forenameInitials: MC affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Sandbu R forenameInitials: R affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Nordstrand N forenameInitials: N affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Hofsø D forenameInitials: D affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Lindberg M forenameInitials: M affiliation: Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Hertel JK forenameInitials: JK affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. entry contributor: Hjelmesæth J forenameInitials: J affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Generated Narrative: Practitioner #contributor0 name: Gunn Signe Jakobsen Generated Narrative: Practitioner #contributor1 name: Milada Cvancarova Småstuen Generated Narrative: Practitioner #contributor2 name: Rune Sandbu Generated Narrative: Practitioner #contributor3 name: Njord Nordstrand Generated Narrative: Practitioner #contributor4 name: Dag Hofsø Generated Narrative: Practitioner #contributor5 name: Morten Lindberg Generated Narrative: Practitioner #contributor6 name: Jens Kristoffer Hertel Generated Narrative: Practitioner #contributor7 name: Jøran Hjelmesæth Generated Narrative: ArtifactAssessment #meshHeading0 artifact: Citation JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort content type: components (if present) include qualifier codings classifier: Adult freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Bariatric Surgery freeToShare: true component type: qualifier classifier: is Major topic component type: qualifier classifier: adverse effects Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Body Mass Index freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Cohort Studies freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Comorbidity freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Depression freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: complications Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Diabetes Mellitus, Type 2 freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: complications Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Female freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Ferritins freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: blood Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Humans freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Hypertension freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: complications Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Male freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Middle Aged freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Obesity, Morbid freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: complications Components - Type Classifier * is Major topic Yes component type: qualifier classifier: drug therapy Components - Type Classifier * is Major topic No component type: qualifier classifier: surgery Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Remission Induction freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Treatment Outcome freeToShare: true Components - Type Classifier * qualifier is not a major topic
components (if present) include qualifier codings
JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort
Computable Publishing®: MEDLINE-to-FEvIR Converter
This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.
Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities [Journal Article]. Contributors: Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. In: JAMA, PMID 29340680. Published January 16, 2018. Available at: https://pubmed.ncbi.nlm.nih.gov/29340680/.
National Library of Medicine, Index Section
Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.
**Importance:** The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. **Objective:** To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. **Design, Setting, and Participants:** Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included). **Exposures:** Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs. **Main Outcomes and Measures:** Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database. **Results:** Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P < .001). **Conclusions and Relevance:** Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.
Obesity (Silver Spring). 2015 Jan;23(1):37-45
Basic Clin Pharmacol Toxicol. 2010 Feb;106(2):86-94
Surg Obes Relat Dis. 2017 Jun;13(6):962-969
Obesity (Silver Spring). 2014 Aug;22(8):1799-806
Surg Obes Relat Dis. 2014 May-Jun;10(3):516-23
Obesity (Silver Spring). 2014 Jul;22 Suppl 2:S5-39
Lancet Diabetes Endocrinol. 2014 Dec;2(12):963-8
Cochrane Database Syst Rev. 2013 Jan 31;(1):CD004816
Obesity (Silver Spring). 2014 Jan;22(1):5-13
Classifier added by Computable Publishing LLC
Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.
Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.
Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway.
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.