As the problem of obesity continues to increase across much of the Western world we are becoming ever more sensitive to the health risks associated with being very overweight and of the increased death risk arising out of obesity. But just how far can these risks be reduced by undergoing gastric bypass surgery?
A recent study looked at the histories of a substantial number of people who had undergone bariatric surgery in the 10 years from 1995 to 2004 and found that in the region of one percent of patients died within twelve months of surgery while roughly 6 percent died inside 5 years. When the numbers had been adjusted for sex and age and matched against statistics for the population at large they were found to be relatively high. So exactly what does this say about the ability of gastric bypass surgery to lower the general risk to our health?
If we want to find the answer this particular question we have to look behind the headline numbers and discover why these deaths happened and where the true variation lies between weight loss patients and the population at large.
When we study the detailed numbers two particular things stand out.
The first is the number of patients who died from heart disease which was the major cause of death in the obesity patients and is well higher than that seen in the general population.
The second is the number of deaths that resulted from suicide and drug overdoses that, while not officially classified as suicide, must nevertheless raise the question of whether or not these overdoses were really accidental. Within the general population you would expect to see roughly 2 suicides in a group of the same size as that used in the study and yet the study group showed 16 suicides and 14 deaths from drug overdoses.
When we look at these findings and consider them alongside our general knowledge about people having gastric bypass surgery then we may perhaps be able to understand this variation to a certain degree.
In spite of the fact that gastric bypass surgery is frequently very successful it is often not performed until people are suffering from other conditions or comorbidities and, although surgery will cure many of these conditions and lower the risks from others, a lot of people are still at some degree of risk following surgery. For example, in a lot of cases people remain troubled by such things as high blood pressure and diabetes mellitus and it is thus unsurprising that this section of the population at large has an increased risk of heart disease.
Furthermore, while gastric bypass surgery can lead to a large loss in weight a lot of people remain very much overweight for a considerable time following surgery and many people will stay that way for months or years to come.
As a final point, the lifestyle changes following surgery are dramatic and a lot of people find that depression sets in the weeks following their surgery. Indeed a lot of attention is given to the physical affects of weight loss surgery and the need for such things as a strict diet and exercise but, all too often, little more than lip service is paid to the psychological affects of surgery.
Time will reveal whether this explanation holds water but there is little doubt that improvements to post-operative care for weight loss patients could go a long way to finding a solution for this variation.As the problem of obesity continues to increase across much of the Western world we are becoming ever more sensitive to the health risks associated with being very overweight and of the increased death risk arising out of obesity. But just how far can these risks be reduced by undergoing gastric bypass surgery?
A recent study looked at the histories of a substantial number of people who had undergone bariatric surgery in the 10 years from 1995 to 2004 and found that in the region of one percent of patients died within twelve months of surgery while roughly 6 percent died inside 5 years. When the numbers had been adjusted for sex and age and matched against statistics for the population at large they were found to be relatively high. So exactly what does this say about the ability of gastric bypass surgery to lower the general risk to our health?
If we want to find the answer this particular question we have to look behind the headline numbers and discover why these deaths happened and where the true variation lies between weight loss patients and the population at large.
When we study the detailed numbers two particular things stand out.
The first is the number of patients who died from heart disease which was the major cause of death in the obesity patients and is well higher than that seen in the general population.
The second is the number of deaths that resulted from suicide and drug overdoses that, while not officially classified as suicide, must nevertheless raise the question of whether or not these overdoses were really accidental. Within the general population you would expect to see roughly 2 suicides in a group of the same size as that used in the study and yet the study group showed 16 suicides and 14 deaths from drug overdoses.
When we look at these findings and consider them alongside our general knowledge about people having gastric bypass surgery then we may perhaps be able to understand this variation to a certain degree.
In spite of the fact that gastric bypass surgery is frequently very successful it is often not performed until people are suffering from other conditions or comorbidities and, although surgery will cure many of these conditions and lower the risks from others, a lot of people are still at some degree of risk following surgery. For example, in a lot of cases people remain troubled by such things as high blood pressure and diabetes mellitus and it is thus unsurprising that this section of the population at large has an increased risk of heart disease.
Furthermore, while gastric bypass surgery can lead to a large loss in weight a lot of people remain very much overweight for a considerable time following surgery and many people will stay that way for months or years to come.
As a final point, the lifestyle changes following surgery are dramatic and a lot of people find that depression sets in the weeks following their surgery. Indeed a lot of attention is given to the physical affects of weight loss surgery and the need for such things as a strict diet and exercise but, all too often, little more than lip service is paid to the psychological affects of surgery.
Time will reveal whether this explanation holds water but there is little doubt that improvements to post-operative care for weight loss patients could go a long way to finding a solution for this variation.By: Donald Saunders
