Although weight loss surgery seems like a quick and effective solution for someone who is overweight or obese compared to diet and exercise, the majority of health care professionals warn against the procedure due to complications such as reoperation and, in rare cases, death. Is their argument valid? A recent study published in the Dec. 18 issue of the journal JAMA Surgery revealed that, in spite of perceived complications, people struggling with obesity that underwent bariatric surgery were considered healthier after the operation.
According to the World Health Organization (WHO), out of 1.4 billion overweight adults around the world, 200 million men and 300 million women are considered obese. Around 2.8 million adults die each year as a result of being overweight or obese, making both conditions the fifth leading cause of death worldwide. Obesity can lead to various other health complications including cardiovascular disease, diabetes, musculoskeletal disorders, and certain types of cancer. People with a body mass index (BMI) higher or equal to 30 are considered obese.
"Weight-loss surgery provides substantial effects on weight loss and improves obesity-related conditions in the majority of bariatric patients, although risks of complication, reoperation, and [death] exist," said lead researcher Dr. Su-Hsin Chang from the Washington University School of Medicine. "Death rates are, in general, very low."
Dr. Chang and her colleagues combed through 150 studies based on weight loss surgery, which included 162,000 patients with an average BMI of 46. The research team analyzed three different types of bariatric surgery, including: gastric bypass surgery, in which part of the stomach is surgically closed off, adjustable gastric banding, where a band reduces the actual size of the stomach, and sleeve gastrectomy, which involves removing most of the stomach.
Results showed that the average patient reduced their BMI by 12 to 17 points in the five years following weight loss surgery. The operation was also effective in eliminating obesity-related conditions, such as heart disease, diabetes, and sleep apnea. On the other hand, the rate of complications was measured at 10 to 17 percent. The rate of reoperation was around seven percent and the death rate was between 0.08 and 0.31 percent.
"The extent of weight loss and risks are different across different procedures," Dr. Chang added. "These should be well communicated when the surgical option is offered to obese patients and should be well considered when making decisions."
Out of all three types of weight loss surgery, patients who underwent a sleeve gastrectomy lost the most weight while only displaying minor symptoms of bleeding, infection, and bowel obstruction. Gastric bypass surgery was considered effective for weight loss; however, the research identified more complications in this group, HealthDay reported. Finally, patients who received an adjustable gastric band lost less weight than patients who underwent gastric bypass or sleeve gastrectomy but experienced fewer complications.
Source: Stoll C, Song J, Varela E, Eagon C, Colditz G, Chang S. “The Effectiveness and Risks of Bariatric SurgeryAn Updated Systematic Review and Meta-analysis, 2003-2012.” JAMA Surgery. 2013