Lipid profile changes after pronounced weight loss induced by bariatric surgery

Obesity is often associated with an atherogenic dyslipidemia such as high LDL levels, low HDL levels and hypertriglyceridemia. The noninterventional treatment of obesity by lifestyle modification and pharmacological intervention results in moderate weight loss and is mostly unsatisfactory with respect to long-term success. Bariatric surgery, by contrast, results in profound and long-term weight loss. Several studies report higher HDL-C levels and lower levels of LDL-C and triglycerides, and a less atherogenic composition of the respective lipoproteins following bariatric surgery-induced weight loss. In addition, structural and functional markers for early atherosclerosis such as flow-mediated dilation and carotid artery intima media thickness improve. Most studies found a greater efficiency with respect to weight loss and resolution of comorbidities after malabsorptive and combination operations compared with restrictive operations, although the former led to more serious surgical and nutritional complications.