As the problem of obesity continues to grow in the West people are becoming more and more informed about the health risks of being very overweight and of the increased death risk as a result of obesity. But to what extent are these risks reduced by bariatric surgery?
A recent study examined the records of a substantial number of patients who had undergone obesity surgery from 1995 to 2004 and found that in the region of one percent of patients died within twelve months of their operation while just over 6 percent died inside 5 years. When the statistics had been adjusted for age and sex and matched against statistics for the population at large they were found to be quite high. So what does this tell us about the ability of bariatric surgery to lower the general risk to our health?
In order to find the answer this question we have to look behind the headline numbers and find out just why these deaths happened and where the true variation lies between weight loss patients and the population at large.
When you consider the detailed numbers two particular things stand out.
The first is the number of people who died from heart disease which is the major cause of death in the obesity patients and is well higher than that found in the population as a whole.
The second is the number of deaths which resulted from suicide and from drug overdoses which, while not officially recorded as suicide, must nevertheless raise the question of whether these overdoses were truly accidents. Within the population at large you might expect to find approximately 2 suicides in a group of the same size as the study group and yet this study group showed no fewer than 30 suicides and drug overdoses.
When we examine these findings and consider them alongside our general knowledge of patients undergoing bariatric surgery then we might perhaps be able to explain this variation to a certain degree.
Although gastric bypass surgery is usually extremely successful it is often not performed until patients are suffering from other conditions or comorbidities and, although surgery may cure several of these conditions and lower the risks from others, a lot of patients still remain at some degree of risk following surgery. In a lot of cases for example people remain troubled by things like diabetes and high blood pressure and it is thus unsurprising that this section of the population has an increased risk of heart disease.
Also, while bariatric surgery can result in a considerable reduction in weight a lot of people are still very much overweight for a considerable time following surgery and some people will stay that way for months or years to come.
Lastly, the changes in lifestyle which follow surgery are dramatic and a lot of patients find that depression sets during the months following their operation. Certainly much attention is paid to the physical affects of surgery and the need for things like a strictly controlled diet and exercise but, all too frequently, little attention is paid to the very real psychological affects of surgery.
Only time will show whether or not this explanation is valid but there can be little doubt that improved post-operative care for weight loss surgery patients would go a long way towards solving this difference.
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