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    Death Rates From Causes Other Than Disease continued...

    Patients who had weight loss surgery had death rates from nondisease causes that were 58% greater than people who did not have surgery.

    The study offered few clues about the reason for this. But several previous studies have suggested a link between weight loss surgery and an increase in drug and alcohol abuse and other risk-taking behaviors.

    Adams says the findings highlight the need for better ways to identify psychological "red flags" in patients who are considering weight loss surgery and for assessing mental status after surgery.

    Weight Loss Surgery vs. Dieting

    The second study involved just over 4,000 severely obese patients, half of whom were treated with weight loss surgery and the other half with either no treatment or nonsurgical weight loss interventions like dieting.

    Ten years later, weight loss among the surgery patients averaged 14% to 25%, compared with less than 2% among the nonsurgery patients.

    During the follow-up, 129 deaths occurred among nonsurgery patients, compared with 101 deaths among the surgery group. The number of heart attack deaths were lower in the surgery group (13 vs. 25), as were cancer deaths (29 vs. 47).

    Researcher Claude Bouchard, PhD, of Louisiana State University's Pennington Biomedical Research Center, tells WebMD that the two studies prove that weight loss surgery is a lifesaving option for severely obese patients.

    Consensus Conference Needed

    Bray agrees that weight loss surgery may prove to be a more important weapon in the battle against obesity and obesity-related disease than any previous intervention.

    But he says the benefits and risks of modern approaches to weight loss surgery must be examined before the indications for the surgery are expanded.

    He is calling for a national conference to address the matter. The last such conference was held in 1991.

    "A lot has happened since then, he says. "Laparoscopic surgery has all but replaced the open surgery -- and surgical mortality rates have declined as a result. But there are unanswered questions about which patients will benefit most from this surgery."

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