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Weight Loss Surgery in Middle Age May Not Increase Survival

Obesity Surgery Might Not Help Older Patients Live Longer, Study Suggests
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Weight Loss Surgery and Risk of Death continued...

"In the Swedish research, some of the decreases in mortality found a decade or more later were caused by a reduction in deaths from cancer and heart disease," says Janey Pratt, MD, a bariatric surgeon and director of the Massachusetts General Hospital Weight Loss Center in Boston, who was not involved in either of the two studies. "Perhaps in this latest research, the damage had already been done in older patients, and they're less likely to reap the benefits of surgery in terms of survival.”

Eleven of the 850 surgical patients died within a month of having gastric bypass. That's a mortality rate of 1.3%, which is four times higher than the one seen in an earlier study of weight loss surgery in younger, mostly female patients. 

Pratt tells WebMD that it's much more difficult to do obesity surgery on male patients than females because of gender differences in the way fat is distributed on the body.

Women carry more of their fat in their hips and thighs, and belly fat is found mainly in the abdominal wall. But extremely obese men carry much of their fat in the belly, the so-called "apple" shape. They have thin abdominal walls but lots of fat floating around inside surrounding the gastrointestinal tract and organs where weight loss surgery takes place.

Weighing Risks and Benefits of Obesity Surgery

Roughly 220,000 Americans have obesity surgery per year, or 1% of the clinically eligible population, according to the American Society for Metabolic and Bariatric Surgery. These operations, which include gastric bypass or gastric banding, make the stomach smaller so the amount of food eaten is reduced. With gastric bypass, fewer calories are also absorbed because food bypasses part of the small intestine.

"Even though this study did not suggest a survival benefit at nearly seven years, there are a host of other benefits from having bariatric surgery," Maciejewski tells WebMD. It's effective in producing weight loss, it decreases the use of medication for obesity-related health conditions, such as diabetes, high blood pressure, and high cholesterol, and it improves the quality of life.

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