CoChat
Sign Up
Cited by 1,835Bariatric Surgery and OutcomesBody Contouring and SurgeryObesity, Physical Activity, Diet

Review of the key results from the Swedish Obese Subjects ( SOS ) trial – a prospective controlled intervention study of bariatric surgery

Open access
Sjöström, L.·2013·Journal of Internal Medicine
DOI 10.1111/joim.12012
Open this paper in CoChat — free accountOpen PDF

Abstract

Obesity is a risk factor for diabetes, cardiovascular disease events, cancer and overall mortality. Weight loss may protect against these conditions, but robust evidence for this has been lacking. The Swedish Obese Subjects ( SOS ) study is the first long‐term, prospective, controlled trial to provide information on the effects of bariatric surgery on the incidence of these objective endpoints. The SOS study involved 2010 obese subjects who underwent bariatric surgery [gastric bypass (13%), banding (19%) and vertical banded gastroplasty (68%)] and 2037 contemporaneously matched obese control subjects receiving usual care. The age of participants was 37–60 years and body mass index ( BMI ) was ≥34 kg m −2 in men and ≥38 kg m −2 in women. Here, we review the key SOS study results published between 2004 and 2012. Follow‐up periods varied from 10 to 20 years in different reports. The mean changes in body weight after 2, 10, 15 and 20 years were −23%, −17%, −16% and −18% in the surgery group and 0%, 1%, −1% and −1% in the control group respectively. Compared with usual care, bariatric surgery was associated with a long‐term reduction in overall mortality (primary endpoint) [adjusted hazard ratio ( HR ) = 0.71, 95% confidence interval ( CI ) 0.54–0.92; P = 0.01] and decreased incidences of diabetes (adjusted HR =0.17; P < 0.001), myocardial infarction (adjusted HR = 0.71; P = 0.02), stroke (adjusted HR =0.66; P = 0.008) and cancer (women: adjusted HR = 0.58; P = 0.0008; men: n.s.]. The diabetes remission rate was increased severalfold at 2 years [adjusted odds ratio ( OR ) = 8.42; P < 0.001] and 10 years (adjusted OR = 3.45; P < 0.001). Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/joim.12012

Cites

104 of 104 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Several studies have shown that weight loss of at least 10-15 kg frequently normalises blood glucose in people with short-duration type 2 diabetes.

    “Several studies have now shown that weight loss of at least 10-15 kg frequently normalises blood glucose in people with short-duration type 2 diabetes, and DiRECT did this in a real-life primary care setting. 9-12”

    From Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial (2019) · cites this paper as [10]

    The ‘Effects of bariatric surgery on remission of diabetes’ section reports frequent remission in patients with type 2 diabetes after surgery, including 72% of SOS patients at two years. It does not establish that losing at least 10–15 kg frequently normalises blood glucose specifically in people with short-duration diabetes. The separate claim about DiRECT is not attributed to this 2013 source. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • With Roux-en-Y gastric bypass, maintaining a 25% reduction from presurgical weight is often enough to sustain improvements in health status and quality of life, regardless of nadir percent total weight loss.

    “For example, with Roux-en-Y gastric bypass, maintaining a 25% reduction from presurgical weight is excellent, regardless of nadir percent total weight loss, and is often enough to sustain improvements in health status and quality of life (103).”

    From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [103]

    The Weight changes section reports that gastric-bypass patients averaged 25% below baseline weight at 10 years. The Additional effects of bariatric surgery section reports better health-related quality of life for the surgery group overall. Neither passage establishes that maintaining a 25% loss is sufficient to sustain those improvements for gastric-bypass patients, or that outcomes are independent of nadir weight loss; no page numbers are provided in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Bariatric surgery is an effective way of producing major weight loss and diabetes remissions.

    “Bariatric surgery has dominated discussions of type 2 diabetes remission as an effective way of producing major weight loss and diabetes remissions. 10-12”

    From Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial (2019) · cites this paper as [10]

  • Studies have shown that around 72-75% of patients showed diabetes resolution up to 2 years after bariatric surgery.

    “This might be due to the high remission rates of type II diabetes after bariatric surgery where studies have shown that around 72–75% showed diabetes resolution up to 2 years after surgery [66, 67, 68].”

    From Current treatment of non‐alcoholic fatty liver disease (2022) · cites this paper as [68]

  • The conclusions reported here apply to people with type 2 diabetes diagnosed within the previous 6 years, and existing evidence has shown that remission, though still possible, is less likely after longer durations of disease.

    “The conclusions reported here apply to people with type 2 diabetes diagnosed within the previous 6 years, and existing evidence has shown that remission, though still possible, is less likely after longer durations of disease. 8,10”

    From Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial (2019) · cites this paper as [10]

    The section “Effects of bariatric surgery on remission of diabetes” reports remission after surgery and relapse over follow-up, but it does not compare remission by how long patients had diabetes before treatment. Searches for disease duration and diagnosis within the previous six years found no passage addressing that relationship. The sentence’s statement about whom the citing authors’ own conclusions apply to is not attributed to this source. (LLM, conf=0.70)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Sjöström, L.
Affiliations
University of Gothenburg (SE)
Corresponding author
Sjöström, L.
Venue
Journal of Internal Medicine
Publisher
Wiley
Published
2013-02-08
Volume
273
Issue
3
Pages
219-234
ISSN
  • 0954-6820 (ISSN-L)
  • 1365-2796
DOI
10.1111/joim.12012
OpenAlex
W2027524238
Cited by
1,835
References
104
Citations by year
2026: 72 · 2025: 114 · 2024: 124 · 2023: 157 · 2022: 135 · 2021: 171 · 2020: 174 · 2019: 155 · 2018: 138 · 2017: 133 · 2016: 134 · 2015: 163 · 2014: 115 · 2013: 46 · 2012: 1
FWCI
27.04
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Terveyden ja hyvinvoinnin laitos
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
obesity, gastric bypass, gastric banding, vertical banded gastroplasty, diabetes remission, weight loss, all-cause mortality, cardiovascular disease, myocardial infarction, stroke, cancer incidence, insulin resistance, long-term outcomes, matched control comparison, usual care comparison, body mass index
MeSH terms
Adult, Body Weight, Diabetes Mellitus, Diabetic Angiopathies, Female, Humans, Male, Middle Aged, Neoplasms, Obesity, Morbid, Sweden, Weight Loss, Comorbidity, Body Mass Index, Incidence, Treatment Outcome, Stroke, Bariatric Surgery

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review