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Weight Loss Surgery Makes Life Better for Obese

Gastric Bypass Boosts Mental, Physical Health -- but Complications Common

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"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.

"The Flum paper identifies populations with a higher mortality risk if they undergo weight loss surgery," Wolfe says. "These risks are advanced age, male gender, and lower volume of [weight loss] surgery done by the surgeon and the medical center in question."

What about patients who aren't Medicare beneficiaries? David S. Zingmond, MD, PhD, and colleagues at the UCLA Center for Surgical Outcomes and Quality looked at California patients. Overall, less than 1% of patients died within one year of surgery.

Complications After Weight Loss Surgery

Death isn't the only bad thing that can happen after gastric bypass surgery. There can also be surgical complications. How often do these occur? Zingmond's team looked at this.

They looked at records on the more than 60,000 California patients from 1995 to 2004 who underwent what is now the most common weight loss surgery: the Roux-en-Y gastric bypass.

The first thing Zingmond and colleagues found was that many more people are having the surgery than ever before. Of the 60,000 patients who underwent the operation in the 10-year study period, 11,659 had the operation in 2004 alone.

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