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Bariatric Surgery Associated with Lower Risk of Death among Obese

A retrospective study indicates that patients who undergo bariatric surgery have better survival rates than those who use non-surgical weight loss regimens.

Obesity is considered an important health issue in many countries.  We have long known that an increased body mass index, or BMI, is associated with life-threatening conditions like heart disease, stroke, or diabetes. Health institutions worldwide consider weight management as an integral component of health care.  Clinicians and nutritionists have stressed the importance of proper nutrition and weight management, but these traditional and conservative regimens have had varying degrees of success.

The surgical management of weight loss has gained traction in recent years because of its dramatic results.  Whether by restricting either the entry of food or even reducing the volume of the stomach, bariatric procedures create a physical limitation to the actual amount of food intake.  This limited intake induces the body to mobilize its stored fat for nutrition and energy.  Refinements of technique have both increased the success rates and decreased the complications, and bariatric surgery is now offered as a viable option for the overweight or obese.

With the increasing popularity and availability of these surgical procedures, the researchers wanted to determine their effectiveness in the long-term, and how they stack up against traditional weight management strategies. A 2018 Journal of the American Medical Association research article published the results of an Israeli study, which examined whether patients who underwent weight-reduction surgery were living longer compared to those who chose not to have surgery.

In this study, researchers measured the progress of over 8,000 patients who availed of bariatric surgery over a ten year period.  These patients were then matched against the 25,000 patients who were eligible for the same surgery but opted for conservative weight-management modalities instead.  All of the patients’ records were reviewed for up to five years after the initiation of either weight-loss procedure, to determine how many patients died of any associated medical condition.

Upon review, the mortality rate of those who underwent surgery was pegged at 1.3%, much lower than the 2.3% rate seen in the non-surgical group. This important study demonstrates the effectiveness of bariatric surgery to treat obesity. If validated by longer-term studies, this finding indicates that bariatric surgery procedures may be truly effective in not just taking the weight off, but actually protecting and prolonging the lives of these patients.

Written by Jay Martin, M.D.

Reference: Reges, O, et al.  “Association of Bariatric Surgery Using Laparscoping Banding, Roux-en-Y Gastric Bypass, or Laparoscoptic Sleeve Gastrectomy versus Usual Care Obesity Management with All-Cause Mortality”.  JAMA (2018): 319(3): 279-290.  DOI:  10.10001/jama.2017.20513



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