Study: Gastric bypass reduces death risk in the morbidly obese
Severely obese people who have weight-loss surgery are less likely to die from heart disease, diabetes and cancer seven to 10 years following the procedure than similarly heavy people who don’t have the operation, according to two studies in today’s New England Journal of Medicine.
Researchers at the University of Utah School of Medicine examined data on about 10,000 patients who had gastric bypass surgery, which creates a much smaller stomach, and compared their mortality rates with almost 10,000 severely obese patients who had not had surgery.
During the follow-up period, which averaged seven years, the surgery patients had a slightly higher risk of death from non-disease causes, such as accidents and suicides, but were much less likely to die from heart disease, cancer or diabetes than the control group. Overall, the scientists calculate that death rate declines by 136 per 10,000 operations.
“This certainly demonstrates that those who have the surgery have improved mortality overall,” says lead researcher Ted Adams.
In the second study, scientists in Sweden compared data on 2,010 obese people who had bariatric surgery with 2,037 heavy people who received a range of weight-loss help from no guidance to sophisticated lifestyle intervention. The people who had surgeries lost and kept off a significant amount of weight; those in the control group didn’t. In an average follow-up of 10.9 years after surgery, there were 101 deaths in the surgery group compared with 129 in the control group.
In the USA, gastric bypass is performed on people who are severely obese, 100 or more pounds over a healthy weight. It can be done laparoscopically (a minimally invasive technique using small incisions), or in open surgery. The average cost is about $25,000 to $30,000 for those who don’t have complications. Insurance companies vary widely in their coverage of gastric bypass or gastric banding, in which a band is used to create a very small pouch at the top of the stomach. Under certain conditions, Medicare covers both surgeries.
Losing weight and keeping it off has been shown to improve the health of obese patients, who are more likely to have diabetes, high blood pressure, high cholesterol and sleep apnea.
“These two studies show that bariatric surgery saves lives,” says Philip Schauer, immediate past president of the American Society for Metabolic and Bariatric Surgery.
In an accompanying editorial, George Bray of the Pennington Biomedical Research Center at Louisiana State University-Baton Rouge, says, “the question as to whether intentional weight loss improves life span has been answered, and the answer appears to be a resounding yes.”
