Review finds weight-loss surgery safe and effective

December 18, 2013 by Steven Reinberg, Healthday Reporter
Review finds weight-loss surgery safe and effective
Benefits outweigh risks for many severely obese patients, expert says.

(HealthDay)—A new review finds that weight-loss surgery helps very obese patients drop pounds and improve their overall health, even if there is some risk for complications.

"We've gotten good at doing this," said Dr. Mitchell Roslin, chief of surgery at Lenox Hill Hospital in New York City. "Bariatric surgery has become one of the safest intra-abdominal major procedures."

"The question is why we don't start facing the facts," said Roslin, who was not involved in the new review. "If the data were this good with any other condition, the standard of care for would be surgery."

Roslin said he thinks a bias against obesity tinges the way people look at weight-loss surgery.

"People don't view obesity as a disease, and blame the victim," he said. "We have this ridiculous notion that the next diet is going to be effective—although there has never been an effective diet for people who are severely obese."

Morbid obesity is a chronic condition that is practically irreversible and needs to be treated aggressively, Roslin said. "The only treatment that's effective is surgery," he said.

Review author Su-Hsin Chang is an instructor in the division of public health services at the Washington University School of Medicine, in St. Louis. "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," Chang said. "Death rates are, in general, very low."

"The extent of weight loss and risks are different across different procedures," she said. "These should be well communicated when the surgical option is offered to obese patients and should be well considered when making decisions."

The report was published online Dec. 18 in the journal JAMA Surgery.

For the study, Chang's team analyzed more than 150 studies related to . More than 162,000 patients, with an average body-mass index (BMI) of nearly 46, were included. BMI is a measure of body fat based on height and weight, and a BMI of more than 40 is considered very severely obese.

Overall, complication rates ranged from 10 percent to 17 percent and the reoperation rate was about 7 percent. The death rate ranged from .08 percent to .31 percent.

However, the operation improved obesity-related conditions, such as diabetes, high blood pressure and sleep apnea.

Five years after the operation, the reduction in BMI ranged from 12 to 17 points.

The review showed differences between the types of weight-loss procedures. For example, was more effective for weight loss but was associated with more complications.

In gastric bypass, part of the stomach is closed off to prevent the patient from eating too much.

In adjustable gastric banding, in which a band is used to reduce the size of the stomach, the death and complication rates were lower but reoperation rates were higher. In addition, weight loss with was less than with gastric bypass, the researchers found.

Among all the procedures, sleeve gastrectomy appeared to result in the most weight loss, the researchers said. In this procedure, a large part of the stomach is removed, reducing it to about 25 percent of its original size. This results in a sleeve or tube-like structure.

Roslin said common complications include bleeding, infection and bowel blockage.

Roslin said everyone who has a BMI over 35 and has sleep apnea, severe heart failure or needs insulin for type 2 diabetes should consider having .

"Every patient who needs a joint replacement [and has] a BMI greater than 40 should consider bariatric ," he added.

Explore further: Body contouring improves long-term weight control after gastric bypass

More information: The U.S. National Library of Medicine has more on weight-loss surgery.

Related Stories

Body contouring improves long-term weight control after gastric bypass

October 1, 2013
Body contouring surgery to remove excess skin improves long-term weight control in patients after gastric bypass surgery, reports a study in the October issue of Plastic and Reconstructive Surgery, the official medical journal ...

Jury still out on bariatric surgery for patients with moderate obesity and diabetes

June 4, 2013
Bariatric surgery such as gastric bypass is associated with better short-term control of abnormal blood sugar and more weight loss than conventional nonsurgical therapy in diabetic patients who are moderately obese, but there ...

Bariatric surgical procedures have similar therapeutic benefits in obese adults

November 26, 2012
Obesity is associated with insulin resistance and type 2 diabetes, both of which can be significantly improved by weight loss. Gastric bypass and adjustable gastric banding are two bariatric surgery techniques that are frequently ...

Extent of obesity not strongest factor for patients when choosing weight loss operation

November 22, 2013
A new study investigating why obese patients choose one type of weight loss operation over another reveals that the main factors influencing decision making are whether patients have type 2 diabetes, how much weight they ...

Weight-loss surgery seems to beat diet and exercise

October 23, 2013
(HealthDay)— For people who have a lot of weight to lose, weight-loss surgery appears more effective than diet and exercise, a new review suggests.

Weight-loss surgery provides benefit to high-risk, severely obese patients

May 3, 2012
Among surgeries for obesity, a newer, increasingly popular procedure called sleeve gastrectomy provides more weight loss to high-risk, severely obese patients than adjustable gastric banding, a new study suggests.

Recommended for you

Kids with weight issues at high risk of emotional and behavioural problems

August 10, 2017
A new, in-depth study of New Zealand children and teenagers seeking help with weight issues has found their emotional health and wellbeing is, on average, markedly worse than that of children without weight issues.

Study finds 90 percent of American men overfat

July 24, 2017
Does your waist measure more than half your height?

Are sugary drink interventions changing people's behaviour?

July 19, 2017
An evaluation of efforts designed to reduce how many sugary drinks we consume shows some success in changing younger people's habits but warns they cannot be the only way to cut consumption.

Young adult obesity: A neglected, yet essential focus to reverse the obesity epidemic

July 18, 2017
The overall burden of the U.S. obesity epidemic continues to require new thinking. Prevention of obesity in young adults, while largely ignored as a target for prevention and study, will be critical to reversing the epidemic, ...

Weight gain from early to middle adulthood may increase risk of major chronic diseases

July 18, 2017
Cumulative weight gain over the course of early and middle adulthood may increase health risks later in life, according to a new study led by researchers from Harvard T.H. Chan School of Public Health. They found that, compared ...

Study finds children carry implicit bias towards peers who are overweight

June 23, 2017
Even children as young as 9 years old can carry a prejudice against their peers who are overweight, according to a new study led by Duke Health researchers. They might not even realize they feel this way.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.