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Weight Loss Surgery

Risks of Weight Loss Surgery

Surgery has some real risks, and we make sure our patients fully understand them. Here’s an interesting study published in 2009 in the New England Journal of Medicine:

NEJM – Significant Study on the Safety of Bariatric Surgery
July 30, 2009

One of the most significant studies every conducted on the safety of bariatric surgery has been published in today’s New England Journal of Medicine. The findings of this research very strongly reaffirm the safety of bariatric surgery and should help to inspire greater confidence from the general public and policymakers, thus making it more difficult to deny or delay coverage of these life-saving and life-extending procedures. The safety and effectiveness of bariatric surgery on morbid obesity and expensive obesity-related conditions is emerging as an even more powerful force in this new era of healthcare reform.

"Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery by the Longitudinal Assessment of Bariatric Surgery (LABS) Consortium" N Engl J Med 2009;361:445-54.

Key findings include:

 

  • National Institutes of Health (NIH) study found the risks of bariatric surgery have dropped dramatically and now are no greater than gallbladder or hip replacement surgery
  • Risks are lower than the longer-term risk of dying from heart disease, diabetes and other consequences of carrying more weight than a person’s organs can tolerate
  • At 30 days post-surgery, researchers found the mortality rate among patients who underwent a Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding to be 0.3 percent, and a total of 4.3 percent of patients had at least one major adverse outcome
  • This data should support a higher level of confidence in bariatric surgery among primary care doctors
  • An accompanying editorial stated: "Surgery is safe, effective and affordable" because it can lower the number of doctor visits, medication use and other medical expenses

Study parameters:
 

  • First large-scale study conducted by LABS (Longitudinal Assessment of Bariatric Surgery) – followed 4,776 first-time bariatric surgery patients for 30 days at 10 U.S. hospitals between 2005 and 2007 (3.412 gastric bypass patients and 1,198 gastric band patients, 166 patients had other procedures that were not included in the final analysis)
  • Complication rates were greater in people with a history of clot problems, sleep apnea and certain other medical issues

The study received national media coverage, and commentary from experts (including ASMBS members) were part of the coverage:

  • "Many other studies have compared the odds, and all show a higher risk of dying if you do not have surgical treatment than if you do."
  • "Prior to LABS, the risks and benefits for bariatric surgery had not been thoroughly assessed using multicenter, rigorous methodology."
  • "The surgery is safe. It should give more patients and their primary care providers confidence to look at surgery."
  • "Coronary bypass surgery carries a risk of death 10 times greater than the risk this study found for bariatric surgery."
  • "There’s data that weight loss clearly benefits the health of severely overweight people, and surgery is the most effective way to weight loss."
  • "The very low mortality of bariatric procedures found in this study are consistent with several recent publications which confirm that risk of complications and mortality of bariatric surgery has decreased significantly."

Clinical evidence shows risks of morbid obesity outweigh risks of metabolic and bariatric surgery Individuals with morbid obesity or BMI=30 have a 50-100% increased risk of premature death compared to individuals of healthy weight. Studies show metabolic and bariatric surgery increases life span.

  • Gastric bypass patients may improve life expectancy by 89%
  • Patients may reduce risk of premature death by 30-40%