Beyond slimming the
waistlines of morbidly obese patients, weight-loss surgery also may help
reverse the aging process in some patients, turning back the clock on a key
sign of decline in the body's cells, a small, early study suggests.
Investigators said the
finding could be an unforeseen positive side effect of invasive weight-loss
(bariatric) surgery for some people with cholesterol and inflammation problems.
Such surgery comes in a variety of options, all designed to prompt a dramatic
shedding of pounds following intestinal rerouting or a reduction in stomach
The upshot: One year
following weight-loss surgery, some patients were found to experience a notable
lengthening of the ends of their genes' tips or caps, referred to as
"telomeres". The wearing down and shortening of telomeres over time
has long been viewed as a genetic indicator for aging. Meanwhile, longer
telomeres have been associated with health and youthfulness.
"We know that we age
on a genetic level," said study co-author Dr John Morton, chief of
bariatric and minimally invasive surgery at the Stanford University School of
Medicine. "It's not just about wrinkles. It's the whole system, in which
our body replaces cells continuously. The more they divide over time or the
sicker you are the more the ends get frayed. Like a cap on a shoelace.
"But now we found that
some not all, but some obese patients who lost a lot of weight after surgery
saw significant improvements in telomere length," Morton added. "This
is a pretty unique finding that we haven't seen before."
Morton is scheduled to
present the findings Friday at Obesity Week, the annual meeting of weight-loss
surgeons and other obesity specialists, held in Atlanta.
In recent years, bariatric
surgery has taken its place alongside diet and exercise as a possible intervention
for those struggling to lose weight, particularly among the morbidly obese.
Morbidly obese is defined as those people with a body-mass index (BMI) of at
least 40. BMI is a measurement of body fat based on a ratio of height to
For their current effort,
Morton and his colleagues focused on 51 bariatric surgery patients, with an
average BMI of about 44. On average, the patients were just shy of 49 years
old, and more than three-quarters were women.
The researchers saw that by
the one-year mark following surgery, patients had lost an average of 71% of
so-called "excess" weight.
Such dramatic weight loss
appeared to have a positive impact on key measures of health. For example, a
year after surgery, patients' levels of C-reactive protein (CRP) a sign of
inflammation had plummeted by more than 60% on average. Those who previously
had high levels of so-called "bad" LDL cholesterol also saw their
numbers drop. Meanwhile, fasting insulin levels decreased to just a quarter of
what they had been pre-surgery, suggesting a lower risk for type 2 diabetes.
But blood tests conducted
at three, six and 12 months post-surgery revealed that, among the group as a
whole, telomere length did not change all that much.
However, patients who had
relatively high levels of both CRP and LDL cholesterol before the surgery did
see a significant lengthening of their telomeres, when compared to those with
low CRP and LDL levels pre-surgery.
"All the patients lost
weight and showed big improvements in cardiac health," Morton said.
"But those who had very high inflammation and bad cholesterol before
surgery were found to have longer telomeres following surgery, when
inflammation and bad cholesterol went down. And the lengthening wasn't so
subtle. We're talking about real, significant improvements."
"What this suggests is
that some bariatric surgery patients are metabolically receptive to positive
change that can improve markers for ageing at a genetic level," he said.
Morton said more long-term
research is planned.
Joseph Lee, associate
professor of clinical epidemiology at the Columbia University Mailman School of
Public Health, in New York City, reacted to the current findings with a degree
"Number one, it's a
very small sample of patients," said Lee, a human geneticist. "It's
difficult to make too much out of this. And number two, they measured telomere
length within just 12 months of surgery. Now some people show telomere
lengthening with age. Even some cancer patients show telomere lengthening. So
is what they're seeing a true biological effect resulting from radical surgery,
or is it due to a certain amount of experimental error?"
"It's a very
complicated issue, and I don't think it's really clear what this finding
means," Lee said. "It's certainly an interesting concept. But it
remains to be seen in follow-up, with a larger sample over a much longer period
of time, what's really going on."
For more on weight-loss
surgery, visit the US
National Library of Medicine.