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"After gastric bypass surgery, people describe dramatic, life-altering changes. They feel like they have gotten their lives back," Kolotkin tells WebMD. "They feel vastly more able to have good quality of life and are not so focused on health and weight. They have more energy. They feel better day to day. They feel more productive at work, more sexy, more like going out and being with people and being physically active."

The difference may have been even greater than the study measured. Kolotkin says surgery patients told her that before surgery, they hadn't fully realized the impact their obesity had on their lives.

"People -- the obese themselves as well as others -- are not aware of how much quality of life is impacted by obesity," Kolotkin says. "They are often surprised when they fill out these questionnaires and realize they are suffering many ways in terms of their weight."

Early Death After Weight Loss Surgery

It bears repeating: Obesity is a very serious health problem. And gastric bypass surgery is a very serious surgery.

Death is one possible outcome. Which patients run the highest risk of this worst of all possible adverse events? Clues come from the JAMA paper by David R. Flum, MD, MPH, of the University of Washington in Seattle, and colleagues.

Flum's team looked at the 16,155 Medicare patients who underwent weight loss surgery from 1997 to 2002. Medicare won't pay for this procedure unless a person is ruled to be fully disabled by obesity. That means these patients have a higher burden of disease than the average obese person, notes editorialist Wolfe.

Even so, the numbers are sobering:

  • Overall, 2% of patients died within 30 days of weight loss surgery. Within 90 days, 2.8% died. Within a year, 4.6% died.
  • Men were much more likely to die than women: 3.7% vs. 1.5% within 30 days of weight loss surgery; 4.8% vs. 2.1% within 90 days; and 7.5% vs. 3.7% within 1 year.
  • Patients aged 75 and older were five times more likely to die within 90 days than those aged 65-74.
  • Surgeons with less experience and fewer weight loss surgeries under their belt were 1.6 times more likely to have a patient die within 90 days.

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